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  1. Degree of Postictal Suppression Depends on Seizure Induction Time in Magnetic Seizure Therapy and Electroconvulsive Therapy.

    PubMed

    Kayser, Sarah; Bewernick, Bettina H; Soehle, Martin; Switala, Christina; Gippert, Sabrina M; Dreimueller, Nadine; Schlaepfer, Thomas E

    2017-09-01

    Anesthesia is required for both magnetic seizure therapy (MST) and electroconvulsive therapy (ECT), although it has anticonvulsant properties. In this case, bispectral index (BIS) monitoring, a specific electroencephalogram-derived monitoring, can be used to find the optimal seizure induction time during anesthesia to elicit adequate seizures. A measurement of seizure adequacy in electroencephalogram is the postictal suppression. The purpose of this study was to investigate the influence of seizure induction time on the degree of postictal suppression by comparing BIS versus no-BIS monitoring in MST and ECT. Twenty patients with treatment-resistant depression were randomly assigned to either MST or ECT. Each patient underwent 3 treatments with the determination of seizure induction time by defined prestimulation BIS (BIS condition) and 3 treatments with determination of seizure induction time by controlled clinical trial protocol (no-BIS condition). Statistical analysis was calculated by repeated-measures analysis of variance. The degree of postictal suppression was more pronounced in both MST and ECT, with BIS monitoring. In this connection, no differences between MST and ECT were found. Seizure induction time was significantly later in the BIS condition (181.3 ± 6 seconds) compared with the no-BIS condition (114.3 ± 12 seconds) (P < 0.001). Adequacy of seizures, in the form of the degree of postictal suppression, was superior by determining the seizure induction time with BIS in both MST and ECT. Further research is needed to investigate the correlation between the degree of postictal suppression and treatment response.

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

    PubMed

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

    2013-11-01

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

  3. Individualized Low-Amplitude Seizure Therapy: Minimizing Current for Electroconvulsive Therapy and Magnetic Seizure Therapy

    PubMed Central

    Peterchev, Angel V; Krystal, Andrew D; Rosa, Moacyr A; Lisanby, Sarah H

    2015-01-01

    Electroconvulsive therapy (ECT) at conventional current amplitudes (800–900 mA) is highly effective but carries the risk of cognitive side effects. Lowering and individualizing the current amplitude may reduce side effects by virtue of a less intense and more focal electric field exposure in the brain, but this aspect of ECT dosing is largely unexplored. Magnetic seizure therapy (MST) induces a weaker and more focal electric field than ECT; however, the pulse amplitude is not individualized and the minimum amplitude required to induce a seizure is unknown. We titrated the amplitude of long stimulus trains (500 pulses) as a means of determining the minimum current amplitude required to induce a seizure with ECT (bilateral, right unilateral, bifrontal, and frontomedial electrode placements) and MST (round coil on vertex) in nonhuman primates. Furthermore, we investigated a novel method of predicting this amplitude-titrated seizure threshold (ST) by a non-convulsive measurement of motor threshold (MT) using single pulses delivered through the ECT electrodes or MST coil. Average STs were substantially lower than conventional pulse amplitudes (112–174 mA for ECT and 37.4% of maximum device amplitude for MST). ST was more variable in ECT than in MST. MT explained 63% of the ST variance and is hence the strongest known predictor of ST. These results indicate that seizures can be induced with less intense electric fields than conventional ECT that may be safer; efficacy and side effects should be evaluated in clinical studies. MT measurement could be a faster and safer alternative to empirical ST titration for ECT and MST. PMID:25920013

  4. Magnetic seizure therapy-induced mania: a report of 2 cases.

    PubMed

    Noda, Yoshihiro; Daskalakis, Zafiris J; Fitzgerald, Paul B; Downar, Jonathan; Rajji, Tarek K; Blumberger, Daniel M

    2015-03-01

    Magnetic seizure therapy (MST) is a novel brain stimulation modality used to treat refractory depression through the induction of seizures. It is currently being investigated as a potential alternative treatment to electroconvulsive therapy. To our knowledge, there have not been any previous reports of MST-induced mania. We aim to describe 2 cases of patients with a major depressive episode who developed acute symptoms of mania during a course of MST. The current report describes 2 cases of mania that occurred in the context of an ongoing open-label study of MST in treatment-resistant depression. The MST was administered 2 or 3 times per week and applied directly over the left and right dorsolateral prefrontal cortex. Treatment is administered until patients achieve remission or a maximum of 24 treatments. A MagVenture Twin coil and MST stimulator were used for treatment. The center of each coil was placed over F3 and F4 according to the 10-20 electroencephalography system. Patient 1 had developed manic symptoms precipitously after the sixth MST treatment, and patient 2 developed manic symptoms after the 23rd MST treatment. In both patients, the MST treatment course was stopped. Their manic symptoms resolved rapidly with pharmacotherapy after cessation of MST treatments. As with electroconvulsive therapy, switches to mania or hypomania should be considered as potential adverse effects of MST.

  5. An overview on clinical aspects in magnetic seizure therapy.

    PubMed

    Engel, Alice; Kayser, Sarah

    2016-10-01

    The aim of the presented work is to provide an overview on the clinical data of the promising convulsive brain stimulation technique, the magnetic seizure therapy (MST). We review the advantages and disadvantages of MST, focusing on rationale, development and current treatment procedure. We also provide a summary of the current literature including clinical trials and case reports found in the PubMed database. Furthermore, we consider effectiveness and side effects, emphasizing on crucial issues to be addressed for a better understanding of this potential new treatment option in treatment-resistant depression (TRD).

  6. Transportability of Multisystemic Therapy to Community Settings: Can a Program Sustain Outcomes without MST Services Oversight?

    ERIC Educational Resources Information Center

    Smith-Boydston, Julianne M.; Holtzman, Rochelle J.; Roberts, Michael C.

    2014-01-01

    Background: Multisystemic therapy (MST) has been shown to be effective in treating delinquent behavior in youth. However, some community agencies with MST programs are unable to afford the ongoing costs of licensure and quality assurance oversight provided by MST services. Objective: The present study utilized retrospective archival analyses of…

  7. Electric field strength and focality in electroconvulsive therapy and magnetic seizure therapy: A finite element simulation study

    PubMed Central

    Deng, Zhi-De; Lisanby, Sarah H.; Peterchev, Angel V.

    2014-01-01

    We present the first computational study comparing the electric field induced by various electroconvulsive therapy (ECT) and magnetic seizure therapy (MST) paradigms. Four ECT electrode configurations (bilateral, bifrontal, right unilateral, and focal electrically administered seizure therapy) and three MST coil configurations (circular, cap, and double cone) were modeled. The model incorporated a modality-specific neural activation threshold. ECT (0.3 ms pulse width) and MST induced maximum electric field in the brain of 2.1–2.5 V/cm and 1.1–2.2 V/cm, corresponding to 6.2–7.2 times and 1.2–2.3 times the neural activation threshold, respectively. The MST electric field is more confined to the superficial cortex compared to ECT. The brain volume stimulated was much higher with ECT (up to 100%) than MST (up to 8.2%). MST with the double cone coil was the most focal and bilateral ECT was the least focal. Our results suggest a possible biophysical explanation of the reduced side effects of MST compared to ECT. Our results also indicate that the conventional ECT pulse amplitude (800–900 mA) is much higher than necessary for seizure induction. Reducing the ECT pulse amplitude should be explored as a potential means of diminishing side effects. PMID:21248385

  8. Electric field strength and focality in electroconvulsive therapy and magnetic seizure therapy: a finite element simulation study

    NASA Astrophysics Data System (ADS)

    Deng, Zhi-De; Lisanby, Sarah H.; Peterchev, Angel V.

    2011-02-01

    We present the first computational study comparing the electric field induced by various electroconvulsive therapy (ECT) and magnetic seizure therapy (MST) paradigms. Four ECT electrode configurations (bilateral, bifrontal, right unilateral, and focal electrically administered seizure therapy) and three MST coil configurations (circular, cap, and double cone) were modeled. The model incorporated a modality-specific neural activation threshold. ECT (0.3 ms pulse width) and MST induced the maximum electric field of 2.1-2.5 V cm-1 and 1.1-2.2 V cm-1 in the brain, corresponding to 6.2-7.2 times and 1.2-2.3 times the neural activation threshold, respectively. The MST electric field is more confined to the superficial cortex compared to ECT. The brain volume stimulated was much larger with ECT (up to 100%) than with MST (up to 8.2%). MST with the double-cone coil was the most focal, and bilateral ECT was the least focal. Our results suggest a possible biophysical explanation of the reduced side effects of MST compared to ECT. Our results also indicate that the conventional ECT pulse amplitude (800-900 mA) is much higher than necessary for seizure induction. Reducing the ECT pulse amplitude should be explored as a potential means of diminishing side effects.

  9. Magnetic seizure therapy in an adolescent with refractory bipolar depression: a case report

    PubMed Central

    Noda, Yoshihiro; Daskalakis, Zafiris J; Downar, Jonathan; Croarkin, Paul E; Fitzgerald, Paul B; Blumberger, Daniel M

    2014-01-01

    Magnetic seizure therapy (MST) has shown efficacy in adult patients with treatment-resistant depression with limited impairment in memory. To date, the use of MST in adolescent depression has not been reported. Here we describe the first successful use of MST in the treatment of an adolescent patient with refractory bipolar depression. This patient received MST in an ongoing open-label study for treatment-resistant major depression. Treatments employed a twin-coil MST apparatus, with the center of each coil placed over the frontal cortex (ie, each coil centered over F3 and F4). MST was applied at 100 Hz and 100% machine output at progressively increasing train durations. Depressive symptoms were assessed using the 24-item Hamilton Depression Rating Scale and cognitive function was assessed with a comprehensive neuropsychological battery. This adolescent patient achieved full remission of clinical symptoms after an acute course of 18 MST treatments and had no apparent cognitive decline, other than some autobiographical memory impairment that may or may not be related to the MST treatment. This case report suggests that MST may be a safe and well tolerated intervention for adolescents with treatment-resistant bipolar depression. Pilot studies to further evaluate the effectiveness and safety of MST in adolescents warrant consideration. PMID:25382978

  10. Magnetic Seizure Therapy for Unipolar and Bipolar Depression: A Systematic Review

    PubMed Central

    Cretaz, Eric; Brunoni, André R.

    2015-01-01

    Objective. Magnetic seizure therapy (MST) is a novel, experimental therapeutic intervention, which combines therapeutic aspects of electroconvulsive therapy (ECT) and transcranial magnetic stimulation, in order to achieve the efficacy of the former with the safety of the latter. MST might prove to be a valuable tool in the treatment of mood disorders, such as major depressive disorder (MDD) and bipolar disorder. Our aim is to review current literature on MST. Methods. OVID and MEDLINE databases were used to systematically search for clinical studies on MST. The terms “magnetic seizure therapy,” “depression,” and “bipolar” were employed. Results. Out of 74 studies, 8 met eligibility criteria. There was considerable variability in the methods employed and samples sizes were small, limiting the generalization of the results. All studies focused on depressive episodes, but few included patients with bipolar disorder. The studies found reported significant antidepressant effects, with remission rates ranging from 30% to 40%. No significant cognitive side effects related to MST were found, with a better cognitive profile when compared to ECT. Conclusion. MST was effective in reducing depressive symptoms in mood disorders, with generally less side effects than ECT. No study focused on comparing MST to ECT on bipolar depression specifically. PMID:26075100

  11. Magnetic seizure therapy in treatment-resistant depression: clinical, neuropsychological and metabolic effects.

    PubMed

    Kayser, S; Bewernick, B H; Matusch, A; Hurlemann, R; Soehle, M; Schlaepfer, T E

    2015-04-01

    Magnetic seizure therapy (MST), despite being in an early phase of clinical research, has been demonstrated to be associated with antidepressant efficacy. However, safety, tolerability and efficacy data in connection with functional brain activity from larger samples are lacking. The aim of this study was to determine clinical and cognitive effects of MST and the influence of MST on regional brain glucose metabolism. Twenty-six patients suffering from treatment-resistant depression (TRD) underwent MST. Ten patients underwent a randomized trial and 16 patients an open-label study design. The primary outcome criterion was the severity of depressive symptoms assessed with the Hamilton Depression Rating Scale (HAMD). Depressive symptoms, tolerability and cognitive safety, along with social functioning and quality of life parameters, were assessed using various rating scales. A clinical follow-up visit 6 months following the completion of a course of MST and [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) scans of 12 patients were analysed. A significant response to MST was demonstrated by 69% of the patient sample, with 46% meeting remission criteria. Anxiety ratings were significantly reduced in responders and their quality of life was improved. Half of the responders relapsed within 6 months. No cognitive side-effects were observed. FDG-PET scans showed a metabolic increase in the frontal cortex bilaterally and a decrease in the left striatum. Robust antidepressant and anti-anxiety efficacy of MST was demonstrated, and found to be associated with localized metabolic changes in brain areas that are strongly implicated in depression. Thus, MST presents an effective, well-tolerated and safe treatment option for patients unable to respond to other forms of therapy for depression.

  12. Effect of anatomical variability on electric field characteristics of electroconvulsive therapy and magnetic seizure therapy: a parametric modeling study

    PubMed Central

    Deng, Zhi-De; Lisanby, Sarah H.; Peterchev, Angel V.

    2014-01-01

    Electroconvulsive therapy (ECT) and magnetic seizure therapy (MST) are conventionally applied with a fixed stimulus current amplitude, which may result in differences in the neural stimulation strength and focality across patients due to interindividual anatomical variability. The objective of this study is to quantify the effect of head anatomical variability associated with age, sex, and individual differences on the induced electric field characteristics in ECT and MST. Six stimulation modalities were modeled including bilateral and right unilateral ECT, focal electrically administered seizure therapy (FEAST), and MST with circular, cap, and double-cone coils. The electric field was computed using the finite element method in a parameterized spherical head model representing the variability in the general population. Head tissue layer thicknesses and conductivities were varied to examine the impact of interindividual anatomical differences on the stimulation strength, depth, and focality. Skull conductivity most strongly affects the ECT electric field, whereas the MST electric field is independent of tissue conductivity variation in this model but is markedly affected by differences in head diameter. Focal ECT electrode configurations such as FEAST is more sensitive to anatomical variability than that of less focal paradigms such as BL ECT. In MST, anatomical variability has stronger influence on the electric field of the cap and circular coils compared to the double-cone coil, possibly due to the more superficial field of the former. The variability of the ECT and MST electric field due to anatomical differences should be considered in the interpretation of existing studies and in efforts to improve dosing approaches for better control of stimulation strength and focality across patients, such as individualization of the current amplitude. The conventional approach to individualizing dosage by titrating the number of pulses cannot compensate for differences in

  13. Effect of anatomical variability on electric field characteristics of electroconvulsive therapy and magnetic seizure therapy: a parametric modeling study.

    PubMed

    Deng, Zhi-De; Lisanby, Sarah H; Peterchev, Angel V

    2015-01-01

    Electroconvulsive therapy (ECT) and magnetic seizure therapy (MST) are conventionally applied with a fixed stimulus current amplitude, which may result in differences in the neural stimulation strength and focality across patients due to interindividual anatomical variability. The objective of this study is to quantify the effect of head anatomical variability associated with age, sex, and individual differences on the induced electric field characteristics in ECT and MST. Six stimulation modalities were modeled including bilateral and right unilateral ECT, focal electrically administered seizure therapy (FEAST), and MST with circular, cap, and double-cone coils. The electric field was computed using the finite element method in a parameterized spherical head model representing the variability in the general population. Head tissue layer thicknesses and conductivities were varied to examine the impact of interindividual anatomical differences on the stimulation strength, depth, and focality. Skull conductivity most strongly affects the ECT electric field, whereas the MST electric field is independent of tissue conductivity variation in this model but is markedly affected by differences in head diameter. Focal ECT electrode configurations such as FEAST is more sensitive to anatomical variability than that of less focal paradigms such as BL ECT. In MST, anatomical variability has stronger influence on the electric field of the cap and circular coils compared to the double-cone coil, possibly due to the more superficial field of the former. The variability of the ECT and MST electric fields due to anatomical differences should be considered in the interpretation of existing studies and in efforts to improve dosing approaches for better control of stimulation strength and focality across patients, such as individualization of the current amplitude. The conventional approach to individualizing dosage by titrating the number of pulses cannot compensate for differences in

  14. The use of ECT and MST in treating depression.

    PubMed

    Allan, Charlotte L; Ebmeier, Klaus P

    2011-10-01

    Electroconvulsive therapy (ECT) has been used clinically since 1938. Its most common use is in the treatment of depression: first line treatment where rapid recovery is a priority, but more frequently as an effective treatment for patients who do not respond to pharmacological and psychological approaches. Whilst it is widely hailed as an effective treatment, concerns about its effect on cognition remain. The development of magnetic seizure therapy (MST) over the past decade has attempted to devise a therapy with comparable efficacy to ECT, but without the associated cognitive side effects. The rationale for this is that MST uses magnetic fields to induce seizures in the cortex, without electrical stimulation of brain structures involved with memory. MST has been used successfully in the treatment of depression, yet there is a dearth of literature in comparison with ECT. We present a systematic review of the literature on ECT (from 2009-2011) and MST (from 2001-2011).

  15. Comparison of electric field strength and spatial distribution of electroconvulsive therapy and magnetic seizure therapy in a realistic human head model

    PubMed Central

    Lee, Won Hee; Lisanby, Sarah H.; Laine, Andrew F.; Peterchev, Angel V.

    2017-01-01

    Background This study examines the strength and spatial distribution of the electric field induced in the brain by electroconvulsive therapy (ECT) and magnetic seizure therapy (MST). Methods The electric field induced by standard (bilateral, right unilateral, and bifrontal) and experimental (focal electrically administered seizure therapy and frontomedial) ECT electrode configurations as well as a circular MST coil configuration was simulated in an anatomically realistic finite element model of the human head. Maps of the electric field strength relative to an estimated neural activation threshold were used to evaluate the stimulation strength and focality in specific brain regions of interest for these ECT and MST paradigms and various stimulus current amplitudes. Results The standard ECT configurations and current amplitude of 800–900 mA produced the strongest overall stimulation with median of 1.8–2.9 times neural activation threshold and more than 94% of the brain volume stimulated at suprathreshold level. All standard ECT electrode placements exposed the hippocampi to suprathreshold electric field, although there were differences across modalities with bilateral and right unilateral producing respectively the strongest and weakest hippocampal stimulation. MST stimulation is up to 9 times weaker compared to conventional ECT, resulting in direct activation of only 21% of the brain. Reducing the stimulus current amplitude can make ECT as focal as MST. Conclusions The relative differences in electric field strength may be a contributing factor for the cognitive sparing observed with right unilateral compared to bilateral ECT, and MST compared to right unilateral ECT. These simulations could help understand the mechanisms of seizure therapies and develop interventions with superior risk/benefit ratio. PMID:27318858

  16. Liposteroid therapy for refractory seizures in children.

    PubMed

    Yoshikawa, H; Yamazaki, S; Abe, T; Oda, Y

    2000-10-01

    Liposteroid is dexamethasone palmitate incorporated into liposomes and was developed as an anti-inflammatory drug for targeting therapy mainly for rheumatoid arthritis. Recently, it was reported that liposteroid might be effective for the treatment of West syndrome, with fewer side effects than those of corticotropin therapy. We describe three patients, a 2-month-old boy with early infantile epileptic encephalopathy, a 4-month-old girl with symptomatic West syndrome, and a 2-year-old girl with symptomatic localization-related epilepsy, whose refractory seizures were treated with liposteroid according to the original method reported by Yamamoto and colleagues in 1998. Uncontrollable seizures ceased completely in two patients and the seizure frequency decreased markedly in the other patient. Electroencephalograms revealed marked improvement in all patients. They showed no relapse of the seizures, and all showed no adverse effects except for mild brain shrinkage in one patient. Our experience with these three patients suggests that liposteroid therapy might be a new option for the treatment of refractory seizures in children, as well as for West syndrome.

  17. Controlling stimulation strength and focality in electroconvulsive therapy via current amplitude and electrode size and spacing: comparison with magnetic seizure therapy.

    PubMed

    Deng, Zhi-De; Lisanby, Sarah H; Peterchev, Angel V

    2013-12-01

    Understanding the relationship between the stimulus parameters of electroconvulsive therapy (ECT) and the electric field characteristics could guide studies on improving risk/benefit ratio. We aimed to determine the effect of current amplitude and electrode size and spacing on the ECT electric field characteristics, compare ECT focality with magnetic seizure therapy (MST), and evaluate stimulus individualization by current amplitude adjustment. Electroconvulsive therapy and double-cone-coil MST electric field was simulated in a 5-shell spherical human head model. A range of ECT electrode diameters (2-5 cm), spacing (1-25 cm), and current amplitudes (0-900 mA) was explored. The head model parameters were varied to examine the stimulus current adjustment required to compensate for interindividual anatomical differences. By reducing the electrode size, spacing, and current, the ECT electric field can be more focal and superficial without increasing scalp current density. By appropriately adjusting the electrode configuration and current, the ECT electric field characteristics can be made to approximate those of MST within 15%. Most electric field characteristics in ECT are more sensitive to head anatomy variation than in MST, especially for close electrode spacing. Nevertheless, ECT current amplitude adjustment of less than 70% can compensate for interindividual anatomical variability. The strength and focality of ECT can be varied over a wide range by adjusting the electrode size, spacing, and current. If desirable, ECT can be made as focal as MST while using simpler stimulation equipment. Current amplitude individualization can compensate for interindividual anatomical variability.

  18. Applications of transcranial magnetic stimulation and magnetic seizure therapy in the study and treatment of disorders related to cerebral aging.

    PubMed

    Luber, Bruce; McClintock, Shawn M; Lisanby, Sarah H

    2013-03-01

    Transcranial magnetic stimulation (TMS) can be used to probe cortical function and treat neuropsychiatric illnesses. TMS has demonstrated neuroplastic effects akin to long-term potentiation and long-term depression, and therapeutic applications are in development for post-stroke recovery, Alzheimer's disease, and depression in seniors. Here, we discuss two new directions of TMS research relevant to cerebral aging and cognition. First, we introduce a paradigm for enhancing cognitive reserve, based on our research in sleep deprivation. Second, we discuss the use of magnetic seizure therapy (MST) to spare cognitive functions relative to conventional electroconvulsive therapy, and as a means of providing a more potent antidepressant treatment when subconvulsive TMS has shown modest efficacy in seniors. Whether in the enhancement of cognition as a treatment goal, or in the reduction of amnesia as a side effect, these approaches to the use of TMS and MST merit further exploration regarding their clinical potential.

  19. Ketogenic diet therapy is effective in encephalitis with refractory seizures.

    PubMed

    Matsuzono, Kosuke; Kurata, Tomoko; Deguchi, Shoko; Yamashita, Toru; Deguchi, Kentaro; Abe, Koji

    2014-10-01

    Although ketogenic diet therapy is effective in refractory seizures in childhood, its effect on adult encephalitis with similar refractory seizures and prolonged encephalopathy has not been well reported. We report here a case of a 22-year-old man with acute encephalitis with refractory repetitive partial seizures (AERRPS). Partial seizures of the face developed to repeated generalized convulsions, which were refractory against anti-epileptic drugs and a high dose of propofol. After struggling for 9 months, he dramatically recovered after ketogenic diet therapy. Ketogenic diet therapy may be an important tool to help cure AERRPS.

  20. Augmentation of seizure induction in electroconvulsive therapy: a clinical reappraisal.

    PubMed

    Datto, Catherine; Rai, Anil K; Ilivicky, Howard J; Caroff, Stanley N

    2002-09-01

    Missed or abortive seizures during electroconvulsive therapy (ECT) may preclude completion of an effective course of treatment in some cases. Seizure augmentation, using proconvulsant agents, has been used to overcome resistance to the induction and continuation of seizure activity. In this review, we analyze published clinical data on the effects and safety of seizure augmentation techniques. Clinical studies and case reports were obtained through a MEDLINE literature search from 1966 to 2001, cross-referencing ECT and proconvulsant agents. Article references were also scanned for relevant studies. Data from clinical trials indicate that augmentation facilitates seizure induction when maximal electrical stimuli fail. Anesthetic modifications, including hyperventilation and substitution with etomidate, ketamine, or other agents, often are successful in overcoming seizure resistance and compare favorably with the use of caffeine. In a few studies, augmentation enabled the use of lower stimulus intensities and fewer treatments without loss of efficacy, even in patients not resistant to seizure induction. However, effects of proconvulsants must be reconciled with increasing evidence of the importance of stimulus dosing relative to seizure threshold and other parameters, now considered key to the efficacy of ECT. Further investigations of pharmacologic augmentation could facilitate the administration of ECT and could provide further insights concerning parameters of seizure efficacy and the mechanism of action underlying convulsive therapies.

  1. Seizures

    MedlinePlus

    ... Your 1- to 2-Year-Old First Aid: Seizures KidsHealth > For Parents > First Aid: Seizures Print A A A en español Folleto de instructiones: Convulsiones (Seizures) Although seizures can be frightening, many last only ...

  2. Controlling stimulation strength and focality in electroconvulsive therapy via current amplitude and electrode size and spacing: comparison with magnetic seizure therapy

    PubMed Central

    Deng, Zhi-De; Lisanby, Sarah H.; Peterchev, Angel V.

    2013-01-01

    Objectives Understanding the relationship between the stimulus parameters of electroconvulsive therapy (ECT) and the electric field characteristics could guide studies on improving risk/benefit ratio. We aim to determine the effect of current amplitude and electrode size and spacing on the ECT electric field characteristics, compare ECT focality with magnetic seizure therapy (MST), and evaluate stimulus individualization by current amplitude adjustment. Methods ECT and double-cone-coil MST electric field was simulated in a 5-shell spherical human head model. A range of ECT electrode diameters (2–5 cm), spacing (1–25 cm), and current amplitudes (0–900 mA) were explored. The head model parameters were varied to examine the stimulus current adjustment required to compensate for interindividual anatomical differences. Results By reducing the electrode size, spacing, and current, the ECT electric field can be more focal and superficial without increasing scalp current density. By appropriately adjusting the electrode configuration and current, the ECT electric field characteristics can be made to approximate those of MST within 15%. Most electric field characteristics in ECT are more sensitive to head anatomy variation than in MST, especially for close electrode spacing. Nevertheless, ECT current amplitude adjustment of less than 70% can compensate for interindividual anatomical variability. Conclusions The strength and focality of ECT can be varied over a wide range by adjusting the electrode size, spacing, and current. If desirable, ECT can be made as focal as MST while using simpler stimulation equipment. Current amplitude individualization can compensate for interindividual anatomical variability. PMID:24263276

  3. Seizure Adequacy Markers and the Prediction of Electroconvulsive Therapy Response.

    PubMed

    Minelli, Alessandra; Abate, Maria; Zampieri, Elisa; Gainelli, Giulio; Trabucchi, Luigi; Segala, Matilde; Sartori, Riccardo; Gennarelli, Massimo; Conca, Andreas; Bortolomasi, Marco

    2016-06-01

    Electroconvulsive therapy (ECT) is the most effective therapy for patients with treatment-resistant depression; however, some patients do not respond or relapse in a short time. Electroconvulsive therapy stimulus parameters may be related to the outcome. We carried out a retrospective study review to investigate various ECT parameters in relation to the outcome, clinical variables, and pharmacological treatments. Our aim was to understand which factors could be considered putative seizure quality markers and which are relevant to clinical practice. Two physicians evaluated the seizure length, the postictal suppression index, the wave amplitude, tachycardia, and hemispheric brain wave synchronicity in a double-blind manner for 45 treatment-resistant depression patients receiving ECT. The analysis showed a significant association between the outcome and the ECT seizure quality measured by the parameters (P = 9.9 × 10). Among patients with poor-quality seizures, 61.5% relapsed after approximately 1 month from the last ECT session. Particularly, there was an association between higher symptomatology decrease and higher quality of hemispheric brain wave synchronicity (P = 5.0 × 10), as well as a higher wave amplitude (P = 0.01). Our results confirm that ECT seizure quality was strongly correlated with the decrease of depressive symptomatology.

  4. Seizures

    MedlinePlus

    ... often with a loss of or change in consciousness. Seizures can be frightening, but most last only ... unusual sensations, uncontrollable muscle spasms, and loss of consciousness. Some seizures may be due to another medical ...

  5. Seizures

    MedlinePlus

    ... because of sudden, abnormal electrical activity in the brain. When people think of seizures, they often think of convulsions in which a person's body shakes rapidly and uncontrollably. Not all seizures ... part of the brain. Generalized seizures are a result of abnormal activity ...

  6. Blueprints in Sweden. Symptom load in Swedish adolescents in studies of Functional Family Therapy (FFT), Multisystemic Therapy (MST) and Multidimensional Treatment Foster Care (MTFC).

    PubMed

    Gustle, Lars-Henry; Hansson, Kjell; Sundell, Knut; Lundh, Lars-Gunnar; Löfholm, Cecilia Andrée

    2007-01-01

    The purpose of the present study was to compare symptom load in youth groups treated with three Swedish Blueprint programmes - Functional Family Therapy (FFT), Multisystemic Therapy (MST) and Multidimensional Treatment Foster Care (MTFC) - to see if symptom load matches the intensity of the treatment model as expected. These youth groups were also compared with in- and outpatients from child and adolescent psychiatry, and a normal comparison group. In addition, we compared the symptom load of their mothers. Symptom load was measured by the Achenbach System of Empirically Based Assessment (ASEBA) in the adolescents, and by the Symptom Checklist 90 in their mothers. The results showed that youth in the MST and MTFC studies had a higher symptom load than in the FFT study, and the same pattern of results was found in their mothers. It is concluded that there seems to be a reasonable correspondence between the offered resources and the symptom load among youth and parents; treatment methods with higher intensity have been offered to youth with higher symptom load. The correlation between internalized and externalized symptoms was high in all study groups. The MST and MTFC groups had an equally high total symptom load as the psychiatric inpatient sample.

  7. Seizures

    MedlinePlus

    ... entire body Sudden falling Tasting a bitter or metallic flavor Teeth clenching Temporary stop in breathing Uncontrollable ... Causes of seizures can include: Abnormal levels of sodium or glucose in the blood Brain infection, including ...

  8. Synergistic GABA-Enhancing Therapy against Seizures in a Mouse Model of Dravet Syndrome

    PubMed Central

    Oakley, John C.; Cho, Alvin R.; Cheah, Christine S.; Scheuer, Todd

    2013-01-01

    Seizures remain uncontrolled in 30% of patients with epilepsy, even with concurrent use of multiple drugs, and uncontrolled seizures result in increased morbidity and mortality. An extreme example is Dravet syndrome (DS), an infantile-onset severe epilepsy caused by heterozygous loss of function mutations in SCN1A, the gene encoding the brain type-I voltage-gated sodium channel NaV1.1. Studies in Scn1a heterozygous knockout mice demonstrate reduced excitability of GABAergic interneurons, suggesting that enhancement of GABA signaling may improve seizure control and comorbidities. We studied the efficacy of two GABA-enhancing drugs, clonazepam and tiagabine, alone and in combination, against thermally evoked myoclonic and generalized tonic-clonic seizures. Clonazepam, a positive allosteric modulator of GABA-A receptors, protected against myoclonic and generalized tonic-clonic seizures. Tiagabine, a presynaptic GABA reuptake inhibitor, was protective against generalized tonic-clonic seizures but only minimally protective against myoclonic seizures and enhanced myoclonic seizure susceptibility at high doses. Combined therapy with clonazepam and tiagabine was synergistic against generalized tonic-clonic seizures but was additive against myoclonic seizures. Toxicity determined by rotorod testing was additive for combination therapy. The synergistic actions of clonazepam and tiagabine gave enhanced seizure protection and reduced toxicity, suggesting that combination therapy may be well tolerated and effective for seizures in DS. PMID:23424217

  9. Neonatal seizures: controversies and challenges in translating new therapies from the lab to the isolette

    PubMed Central

    Chapman, Kevin E.; Raol, Yogendra H.; Brooks-Kayal, Amy

    2012-01-01

    Neonatal seizures have unique properties that have proved challenging for both clinicians and basic science researchers. Clinical therapies aimed at neonatal seizures have proven only partially effective and new therapies are slow to develop. This article will discuss neonatal seizures within the framework of the barriers that exist to the development of new therapies and the challenges inherent in bringing new therapies from the bench to the bedside. With the European Union and United States creating national collaborative project infrastructure, improved collaborative resources should advance clinical research on urgently needed new therapies for this disorder. PMID:22708596

  10. [Multisystemic Therapy (MST) for adolescents with severe conduct disorders in German-speaking Switzerland - implementation and first results].

    PubMed

    Rhiner, Bruno; Graf, Thomas; Dammann, Gerhard; Fürstenau, Ute

    2011-01-01

    To determine the extent to which MST can be applied in German-speaking Switzerland, and the extent to which respectable international treatment outcomes can be replicated. A sample of 70 adolescents was treated for an average of 155 days. Of these adolescents, 60 (85.5 %) remained in the study until the conclusion of treatment. The results of the parent version of the Strengths and Difficulties Questionnaire (SDQ) are available for 38 (63.3 %) of the completers. For 52 patients (86.7 %), the therapist ratings for Values for Clinical Global Impression (CGI) and for Global Assessment of Functioning (GAF) are available. The overall problem score of the parent version of the SDQ was reduced from 20 at the beginning of treatment to 14.6 at the conclusion of treatment. The overall score of the GAF improved from 55.4 to 70.3, and the CGI improved from 3.6 to 2.7 points. These results are statistically highly significant. The 6-month follow-up interview revealed treatment success rates of 91 % for «adolescent remains in his family of origin,» 94 % for «adolescent remains in school or vocational training,» and 91 % for «adolescent does not commit chargeable offences.» The 18-month follow-up interviews show success rates of 80 %, 86 %, and 86 %, respectively. Multisystemic Therapy is a complex treatment program that is clearly applicable in the cultural environment of Switzerland. Respectable international results were replicated in this sample.

  11. Should phenytoin or barbiturates be used as second-line anticonvulsant therapy for toxicological seizures?

    PubMed

    Shah, Anoop S V; Eddleston, Michael

    2010-10-01

    Seizures are a common sequela of self-poisoning. However, their mechanism differs from seizures of other etiologies. Toxicological seizures result from alterations in the excitatory and inhibitory balance of otherwise normal neurons. In contrast, idiopathic or trauma related seizures usually start with a focus of abnormal neurons. For both forms of seizures, benzodiazepines are recommended as first-line therapy; however, there is debate about the use of phenytoin or barbiturates for second-line therapy. In this article, we systematically review the evidence for the use of these drugs as second-line therapy for toxicological seizures. Barbiturates complement the anticonvulsant effect of benzodiazepines at the GABAA receptor by increasing the duration of chloride channel opening; phenytoin blocks voltage-dependent sodium channels to inhibit propagation from active electrical foci, an effect more useful for nontoxicological seizures. We found no randomized controlled trial comparing phenytoin and barbiturates in toxicological seizures refractory to benzodiazepines; similarly no trial was found comparing the use of these drugs in nonpoisoned patients. Animal studies indicate that phenobarbital has greater effectiveness than phenytoin for many poisons; a few case reports suggest a better response in patients. Despite the lack of high-quality clinical trial data, pharmacological knowledge and animal studies suggest that phenobarbital or thiopentone should be second-line agents for controlling toxicological seizures. The role of newer agents such as propofol and levetiracetam in toxicological seizures is currently unclear because of a lack of clinical or animal studies.

  12. Genetic characterization drives personalized therapy for early-stage non-small-cell lung cancer (NSCLC) patients and survivors with metachronous second primary tumor (MST)

    PubMed Central

    Ding, Xingchen; Wang, Linlin; Liu, Xijun; Sun, Xindong; Yu, Jinming; Meng, Xue

    2017-01-01

    Abstract Rationale: The pathogenesis and progression of lung cancer is a complicated process in which many genes take part. But molecular gene testing is typically only performed in advanced-stage non-squamous non-small-cell lung cancer (NSCLC). The value of tyrosine kinase inhibitors (TKI) administration is not widely recognized with respect to early-stage NSCLC. Patient concerns: Here, we present a case of a man, heavy smoker who initially presented with stage IA lung adenocarcinoma (LADC). Three years after a lung lobectomy, he was diagnosed with advanced lung squamous cell carcinoma (SCC), according to laboratory, imaging, and pathological examinations. Diagnoses The case initially had an early-stage LADC with an L858R epidermal growth factor receptor (EGFR) mutation. A subsequent advanced SCC bearing EGFR L858R/T790M mutations occurred 3 years after surgery. Interventions: The comprehensive therapy we utilized, including surgical resection for the early-stage lesion and GP chemotherapy and local radiotherapy as the first line therapy along with gefitinib maintenance treatment for the advanced metachronous second primary tumors (MST). Outcomes: The synthetical therapy, have resulted in our patient with remaining alive and progression free for 4.5 years. Lessons: This case suggests that changes in molecular pathology should be monitored closely throughout cancer progression to guide personalized therapy and improve prognosis. We further review administration of TKI to early-stage NSCLC and to the metachronous second primary tumors (MST) in survivors. PMID:28272214

  13. Assessment of Seizure Severity with Adjunctive Lamotrigine Therapy: Results from a U.S. Observational Study.

    PubMed

    Bryant-Comstock, Lynda; Scott-Lennox, Jane; Lennox, Richard

    2001-04-01

    THE ADJUNCTIVE LAMICTAL (LAMOTRIGINE) IN EPILEPSY: Response to Treatment (ALERT) study was an observational study designed to assess the safety of lamotrigine in patients with refractory partial seizures when used in a general practice setting. We measured the impact of adjunctive lamotrigine therapy for 16 weeks on the severity of seizures using the Liverpool Seizure Severity Scale (LSSS). This questionnaire was scored using a revised scoring procedure that assesses the impact of treatment on the patients "most severe seizure." Data from the LSSS were also compared with physician-rated changes of seizure severity. Patients who completed 16 weeks of lamotrigine treatment showed a significant reduction in LSSS scores when compared with patients who discontinued lamotrigine (change scores: patient's taking lamotrigine at Week 16, 9.2 +/- 23.4; patients who discontinued lamotrigine by Week 16, 0.8 +/- 23.4, P < 0.05). These findings were supported by significant reductions in physician ratings of seizure severity in patients who completed 16 weeks of lamotrigine therapy. Seizure severity is an important outcome in the study of antiepileptic medication. Data from this observational study suggest that lamotrigine is effective in reducing seizure severity when used as an adjunctive therapy in patients with refractory partial seizures.

  14. IS A GRANDMAL SEIZURE NECESSARY AND SUFFICIENT FOR THE EFFICACY OF ELECTRO CONVULSIVE THERAPY?

    PubMed Central

    Verghese, Abraham

    2000-01-01

    This paper highlights the recent research findings which suggest that the old teaching that a grandma! seizure is both necessary and sufficient for the efficacy of electroconvulsive therapy (ECT) is not correct. It is necessary; but not sufficient. The stimulus intensity should be adjusted so that it is far above the seizure threshold in order to get maximum efficacy of ECT. PMID:21407909

  15. Increased endogenous H2S generation by CBS, CSE, and 3MST gene therapy improves ex vivo renovascular relaxation in hyperhomocysteinemia.

    PubMed

    Sen, Utpal; Sathnur, Pushpakumar B; Kundu, Sourav; Givvimani, Srikanth; Coley, Denise M; Mishra, Paras K; Qipshidze, Natia; Tyagi, Neetu; Metreveli, Naira; Tyagi, Suresh C

    2012-07-01

    Hydrogen sulfide (H(2)S) has recently been identified as a regulator of various physiological events, including vasodilation, angiogenesis, antiapoptotic, and cellular signaling. Endogenously, H(2)S is produced as a metabolite of homocysteine (Hcy) by cystathionine β-synthase (CBS), cystathionine γ-lyase (CSE), and 3-mercaptopyruvate sulfurtransferase (3MST). Although Hcy is recognized as vascular risk factor at an elevated level [hyperhomocysteinemia (HHcy)] and contributes to vascular injury leading to renovascular dysfunction, the exact mechanism is unclear. The goal of the current study was to investigate whether conversion of Hcy to H(2)S improves renovascular function. Ex vivo renal artery culture with CBS, CSE, and 3MST triple gene therapy generated more H(2)S in the presence of Hcy, and these arteries were more responsive to endothelial-dependent vasodilation compared with nontransfected arteries treated with high Hcy. Cross section of triple gene-delivered renal arteries immunostaining suggested increased expression of CD31 and VEGF and diminished expression of the antiangiogenic factor endostatin. In vitro endothelial cell culture demonstrated increased mitophagy during high levels of Hcy and was mitigated by triple gene delivery. Also, dephosphorylated Akt and phosphorylated FoxO3 in HHcy were reversed by H(2)S or triple gene delivery. Upregulated matrix metalloproteinases-13 and downregulated tissue inhibitor of metalloproteinase-1 in HHcy were normalized by overexpression of triple genes. Together, these results suggest that H(2)S plays a key role in renovasculopathy during HHcy and is mediated through Akt/FoxO3 pathways. We conclude that conversion of Hcy to H(2)S by CBS, CSE, or 3MST triple gene therapy improves renovascular function in HHcy.

  16. Brain temporal complexity in explaining the therapeutic and cognitive effects of seizure therapy.

    PubMed

    Farzan, Faranak; Atluri, Sravya; Mei, Ye; Moreno, Sylvain; Levinson, Andrea J; Blumberger, Daniel M; Daskalakis, Zafiris J

    2017-04-01

    Over 350 million people worldwide suffer from depression, a third of whom are medication-resistant. Seizure therapy remains the most effective treatment in depression, even when many treatments fail. The utility of seizure therapy is limited due to its cognitive side effects and stigma. The biological targets of seizure therapy remain unknown, hindering design of new treatments with comparable efficacy. Seizures impact the brains temporal dynamicity observed through electroencephalography. This dynamicity reflects richness of information processing across distributed brain networks subserving affective and cognitive processes. We investigated the hypothesis that seizure therapy impacts mood (depressive symptoms) and cognition by modulating brain temporal dynamicity. We obtained resting-state electroencephalography from 34 patients (age = 46.0 ± 14.0, 21 females) receiving two types of seizure treatments-electroconvulsive therapy or magnetic seizure therapy. We used multi-scale entropy to quantify the complexity of the brain's temporal dynamics before and after seizure therapy. We discovered that reduction of complexity in fine timescales underlined successful therapeutic response to both seizure treatments. Greater reduction in complexity of fine timescales in parieto-occipital and central brain regions was significantly linked with greater improvement in depressive symptoms. Greater increase in complexity of coarse timescales was associated with greater decline in cognition including the autobiographical memory. These findings were region and timescale specific. That is, change in complexity in occipital regions (e.g. O2 electrode or right occipital pole) at fine timescales was only associated with change in depressive symptoms, and not change in cognition, and change in complexity in parieto-central regions (e.g. Pz electrode or intra and transparietal sulcus) at coarser timescale was only associated with change in cognition, and not depressive symptoms. Finally

  17. [Anticonvulsive Therapy after the First Unprovoked Seizure – Pros and Cons].

    PubMed

    Zieglgänsberger, Dominik; Tettenborn, Barbara

    2016-01-06

    A first seizure is a critical life time event with severe consequences. A very thorough work-up is needed to find out the cause of the seizure and to number the risk of recurrence. Reasons for an anticonvulsive therapy are a pathologic EEG, a pathologic neurologic examination, the proof of a structural lesion, focal seizure onset or seizure onset while sleeping or classification as an epilepsy syndrome with high recurrence risk like juvenile myoclonic epilepsy or juvenile absence epilepsy. Psychological and social aspects like the patients or relatives fear of a further seizure, the risk of injury and occupational and recreational aspects must be considered as well. Reasons against an anticonvulsive therapy are mainly related to adverse effects like gain of weight and osteoporosis.

  18. Measuring electroencephalographic seizure adequacy during electroconvulsive therapy: a comparison of 2 definitions.

    PubMed

    Rattehalli, Ranganath D; Thirthalli, Jagadisha; Rawat, Vikram; Gangadhar, Bangalore N; Adams, Clive E

    2009-12-01

    The second edition of The ECT Handbook of the Royal College of Psychiatrists gives importance to the pattern of electroencephalographic (EEG) seizure rather than to the duration for measuring seizure adequacy. We examined the potential effect of this change in definition by estimating the restimulation rates in electroconvulsive therapy. The new definition of EEG seizure was applied to 102 computerized EEG recordings obtained during electroconvulsive therapy sessions in an academic institute in India. The EEGs were read by 2 independent researchers blind to each other's ratings and blind to the motor seizure status. All 41 seizures considered "adequate" by the old definition also satisfied the new definition. Only 1 (2%) of the 58 "inadequate" seizures by the old definition was found to be adequate by the new definition. We had a very good interrater agreement on this reclassification (kappa = 0.86). In this sample, a seizure with polyspikes and a 3-Hz activity (new definition) tended to last longer than 25 seconds (old definition), satisfying both definitions. An estimated 2% of the patients with adequate seizures could have been restimulated during the study period.

  19. Bearing Witness: Personal and Poetic Descriptions of Seizure Therapy.

    PubMed

    Fink, Max

    2016-03-01

    Many voices comment on personal experience with induced seizures. The encouraging voices of professionals are contrasted with those in theater and film that stigmatize the treatments. The negative images have done much to support restrictive legislation.

  20. Prevalence, Response to Cysticidal Therapy, and Risk Factors for Persistent Seizure in Indian Children with Neurocysticercosis

    PubMed Central

    Kumar, Animesh; Mandal, Anirban; Sinha, Sheela; Singh, Amitabh

    2017-01-01

    Background. Neurocysticercosis (NCC) is the commonest cause of childhood acquired epilepsy in developing countries. The use of cysticidal therapy in NCC, except “single lesion NCC,” is still debated in view of its doubtful usefulness and potential adverse effects. Methods. Children presenting with first episode of seizure or acute focal neurological deficit without fever were screened for NCC and received appropriate therapy (followup done for 1 year to look for the response and side effects). Results. The prevalence of NCC was 4.5%. Most common presenting feature was generalized seizure and commonest imaging finding was single small enhancing lesion in the parietal lobe. Abnormal EEG and CSF abnormalities were found in almost half of the children. The response to therapy was very good with infrequent recurrence of seizure and adverse effects of therapy were encountered rarely. No risk factors for persistent seizure could be identified. Conclusion. Present study shows that the response to cysticidal therapy is very good in NCC as seizure recurrence was observed in only 5%, 4.2%, and 4.2% of cases at 3-month, 6-month, and 1-year followup. Adverse effects of therapy were observed in 20% of cases during therapy but they were mild and self-limiting. PMID:28167968

  1. Group Dialectical-Behavior Therapy Skills Training for Conversion Disorder With Seizures.

    PubMed

    Bullock, Kim D; Mirza, Nida; Forte, Craig; Trockel, Mickey

    2015-01-01

    Neuroimaging evidence suggests deficits in affective regulation in conversion disorder (CD). Dialectical-behavior therapy skills training (DBT-ST) was developed to target emotion dysregulation. This study was aimed to test the feasibility of stand-alone DBT-ST for CD using Linehan's manual for borderline personality disorder. In a prospective naturalistic design, 19 adult outpatients diagnosed with video EEG-confirmed seizure type CD were recruited and received weekly group DBT. Seventeen out of 19 subjects finished an average of 20.5 weeks of treatment. The mean seizure rate decreased by 66%. Cessation of seizures occurred in 35% of the sample. Completion rates reached 90%.

  2. Combination therapy of levetiracetam and gabapentin against nonconvulsive seizures induced by penetrating traumatic brain injury.

    PubMed

    Lu, Xi-Chun M; Cao, Ying; Mountney, Andrea; Liao, Zhilin; Shear, Deborah A; Tortella, Frank C

    2017-07-01

    Posttraumatic seizures are a medical problem affecting patients with traumatic brain injury. Yet effective treatment is lacking owing to the limitations of antiepileptic drugs (AEDs) applicable to these patients. In this study, we evaluated the dose-response efficacy of levetiracetam (12.5-100.0 mg/kg) and gabapentin (1.25-25.0 mg/kg) administered either individually or in pairs at fixed-dose ratios as a combination in mitigating posttraumatic nonconvulsive seizures induced by severe penetrating ballistic-like brain injury (PBBI) in rats. Seizures were detected by continuous electroencephalogram (EEG) monitoring for 72 hours postinjury. Animals were treated twice per day for 3 days by intravenous injections. Both levetiracetam (25-100 mg/kg) and gabapentin (6.25-25 mg/kg) significantly reduced PBBI-induced seizure frequency by 44% to 73% and 61% to 69%, and seizure duration by 45% to 64% and 70% to 78%, respectively. However, the two drugs manifested different dose-response profiles. Levetiracetam attenuated seizure activity in a dose-dependent fashion, whereas the beneficial effects of gabapentin plateaued across the three highest doses tested. Combined administration of levetiracetam and gabapentin mirrored the more classic dose-response profile of levetiracetam monotherapy. However, no additional benefit was derived from the addition of gabapentin. Furthermore, isobolographic analysis of the combination dose-response profile of levetiracetam and gabapentin failed to reach the expected level of additivity, suggesting an unlikelihood of favorable interactions between these two drugs against spontaneously occurring posttraumatic seizure activities at the particular set of dose ratios tested. This study was the first attempt to apply isobolographic approach to studying AED combination therapy in the context of spontaneously occurring posttraumatic seizures. Despite the failure to achieve additivity from levetiracetam and gabapentin combination, it is important to

  3. Population dose-response analysis of daily seizure count following vigabatrin therapy in adult and pediatric patients with refractory complex partial seizures.

    PubMed

    Nielsen, Jace C; Hutmacher, Matthew M; Wesche, David L; Tolbert, Dwain; Patel, Mahlaqa; Kowalski, Kenneth G

    2015-01-01

    Vigabatrin is an irreversible inhibitor of γ-aminobutyric acid transaminase (GABA-T) and is used as an adjunctive therapy for adult patients with refractory complex partial seizures (rCPS). The purpose of this investigation was to describe the relationship between vigabatrin dosage and daily seizure rate for adults and children with rCPS and identify relevant covariates that might impact seizure frequency. This population dose-response analysis used seizure-count data from three pediatric and two adult randomized controlled studies of rCPS patients. A negative binomial distribution model adequately described daily seizure data. Mean seizure rate decreased with time after first dose and was described using an asymptotic model. Vigabatrin drug effects were best characterized by a quadratic model using normalized dosage as the exposure metric. Normalized dosage was an estimated parameter that allowed for individualized changes in vigabatrin exposure based on body weight. Baseline seizure rate increased with decreasing age, but age had no impact on vigabatrin drug effects after dosage was normalized for body weight differences. Posterior predictive checks indicated the final model was capable of simulating data consistent with observed daily seizure counts. Total normalized vigabatrin dosages of 1, 3, and 6 g/day were predicted to reduce seizure rates 23.2%, 45.6%, and 48.5%, respectively. © 2014, The American College of Clinical Pharmacology.

  4. Randomized-controlled trials of levetiracetam as an adjunctive therapy in epilepsy of multiple seizure types.

    PubMed

    Fang, Youxin; Wu, Xunyi; Xu, Lan; Tang, Xinghua; Wang, Jianhong; Zhu, Guoxing; Hong, Zhen

    2014-01-01

    This meta-analysis aimed to systematically collect and synthesize the current evidence regarding the efficacy and tolerability of levetiracetam (LEV) as an adjunctive therapy for adults and children suffering from idiopathic and secondary epilepsy of multiple seizure types. We selected randomized-controlled trials (RCT) of LEV as an adjunctive therapy in epilepsy according to predefined criteria. Outcome measures included a > or =50% reduction in seizure frequency, seizure freedom, and adverse events. Thirteen RCT were analyzed. Results showed that the efficacy of adjunctive LEV was superior to placebo both in achieving > or =50% reduction in seizure frequency (pooled odds ratio [OR] 3.36, 95% confidence interval [CI] 2.78-4.07, Z=12.46; p<0.00001) and seizure freedom (pooled OR 4.72, 95% CI 2.96-7.54, Z=6.50; p<0.00001). The heterogeneity was mild (chi-squared=12.28, I2=2% in > or =50% reduction in seizure frequency, and chi-squared=0.49, I2=0% in seizure freedom). Subgroup analysis suggested similar effects across different dosages in adults. The incidence of adverse reactions was not significantly different between the LEV group and the placebo group. The adverse events of relatively high incidence in the LEV group included somnolence, agitation, dizziness, asthenia, and infection. Incidence of serious adverse reaction such as rash and white blood cells and platelets decreasing was quite low. Adjunctive therapy with LEV was superior to placebo in reducing the frequency of seizures in patients with partial and idiopathic generalized epilepsy with effect in both adults and children, and demonstrated good tolerance in patients with epilepsy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. The chemical induction of seizures in psychiatric therapy: were flurothyl (indoklon) and pentylenetetrazol (metrazol) abandoned prematurely?

    PubMed

    Cooper, Kathryn; Fink, Max

    2014-10-01

    Camphor-induced and pentylenetetrazol-induced brain seizures were first used to relieve psychiatric illnesses in 1934. Electrical inductions (electroconvulsive therapy, ECT) followed in 1938. These were easier and less expensive to administer and quickly became the main treatment method. In 1957, seizure induction with the inhalant anesthetic flurothyl was tested and found to be clinically effective.For many decades, complaints of memory loss have stigmatized and inhibited ECT use. Many variations of electricity in form, electrode placement, dosing, and stimulation method offered some relief, but complaints still limit its use. The experience with chemical inductions of seizures was reviewed based on searches for reports of each agent in Medline and in the archival files of original studies by the early investigators. Camphor injections were inefficient and were rapidly replaced by pentylenetetrazol. These were effective but difficult to administer. Flurothyl inhalation-induced seizures were as clinically effective as electrical inductions with lesser effects on memory functions. Flurothyl inductions were discarded because of the persistence of the ethereal aroma and the fears induced in the professional staff that they might seize. Persistent complaints of memory loss plague electricity induced seizures. Flurothyl induced seizures are clinically as effective without the memory effects associated with electricity. Reexamination of seizure inductions using flurothyl in modern anesthesia facilities is encouraged to relieve medication-resistant patients with mood disorders and catatonia.

  6. Seizure-freedom with combination therapy in localization-related epilepsy.

    PubMed

    Peltola, Jukka; Peltola, Maria; Raitanen, Jani; Keränen, Tapani; Kharazmi, Elham; Auvinen, Anssi

    2008-04-01

    We analyzed the effect of combination therapy on seizure frequency in all adult patients (N=193) with focal epilepsy followed at a single institution in a cross-sectional study. One hundred and thirty-five patients were on two AEDs, of them, 37 (27%) were seizure-free, 50 patients were on three AEDs including 5 (10%) seizure-free patients (p<0.01 for seizure-freedom with two AEDs versus three AEDs). Thirty-five different combinations were used in patients on two AEDs and 40 combinations on patients on three drugs emphasizing the difficulties involved in evaluation of the efficacy and tolerability of specific combinations. The significant proportion of seizure-free cases (27%) on duotherapy is suggesting the usefulness of combination therapy in achieving seizure-freedom in epilepsies refractory to single drug treatment. The material in the study was not from a randomized trial and therefore the comparability of patients on different AEDs is uncertain, but on the other hand the clinical practice followed provides a natural experiment suitable for comparative, non-randomized assessment of treatment outcomes.

  7. Pretreatment With Caffeine Citrate to Increase Seizure Duration During Electroconvulsive Therapy: A Case Series.

    PubMed

    Pinkhasov, Aaron; Biglow, Michael; Chandra, Subhash; Pica, Tiffany

    2016-04-01

    Due to the shortage of parenteral caffeine and sodium benzoate, patients were pretreated with caffeine citrate to increase therapeutic seizure duration during electroconvulsive therapy (ECT). To date, no data are available on the use of caffeine citrate during ECT. This retrospective case series was done to demonstrate utilization of caffeine citrate as a substitute for caffeine and sodium benzoate in optimizing ECT. Medical records were reviewed to identify patients who received ECT and caffeine citrate. Physician notes were reviewed to determine the parameters of the ECT procedure, the seizure length, and the dose of caffeine citrate. Each chart was thoroughly studied to find the relationship between seizure duration and dose of caffeine citrate. Of the 12 ECT treatments utilizing caffeine citrate, 9 achieved at least 1 session lasting >30 seconds with an average seizure duration of 35 seconds. Increase in seizure duration ranged from -41% to 276% with an average increase of 48%. Only 3 treatment sessions utilizing caffeine citrate showed no increase in seizure duration. Doses ranged from 120 to 600 mg of both oral and parenteral caffeine citrate. Although increase in seizure duration was achieved for the majority of the ECT sessions, no dose-response correlation could be made. No significant adverse reactions were noted with the use of caffeine citrate during ECT. It was determined that, much like caffeine and sodium benzoate, caffeine citrate does increase the seizure duration. However, this response did vary due to many reasons including small sample size, concomitant medications, duration of illness, and number of ECTs they received in the past and how long ago they received the last ECT. Further research is required to elucidate the effect of these variables on seizure duration. © The Author(s) 2014.

  8. M Current-Based Therapies for Nerve Agent Seizures

    DTIC Science & Technology

    2012-07-01

    potassium channel mutation in neonatal human epilepsy. Science 279, 403-406. Bouron, A. & Reuter, H. (1997). Muscarinic stimulation of synaptic activity...KCNQ2 and KCNQ3 expression in human brain: possible contribution to the age-dependent etiology of benign familial neonatal convulsions. Brain Dev 30...Brooks-Kayal, A. R., & Cooper, E. C. (2009). A KCNQ channel opener for experimental neonatal seizures and status epilepticus. Ann Neurol 65, 326-336

  9. Seizure Duration Decreases Over a Course of Bifrontal and Not Bitemporal Electroconvulsive Therapy

    PubMed Central

    Abhishekh, Hulegar A.; Thirthalli, Jagadisha; Hegde, Anusha; Phutane, Vivek H.; Kumar, Channaveerachari N.; Muralidharan, Kesavan; Gangadhar, Bangalore N.

    2014-01-01

    Context: Mechanism of action of electroconvulsive therapy (ECT) is unclear. Anticonvulsant action of ECT has also been one among the hypothesized mechanisms. Anticonvulsant effect may manifest during ECT in at least two ways (a) increased seizure threshold (b) decrease in seizure duration. In depression, increased seizure threshold has been shown to be associated with better antidepressant response. However, relationship between seizure duration and antidepressant activity has been inconsistent. These issues are not investigated in conditions other than depression. Aims: We examined seizure duration over the course of ECT in schizophrenia patients. Settings and Design: Material for this analysis was obtained from a clinical trial examining the differential efficacy of bifrontal ECT (BFECT) versus bitemporal ECT (BTECT) in schizophrenia patients. As a part of study 122 schizophrenia patients who were prescribed ECT were randomized to receive either BFECT or BTECT. Subjects and Methods: Final analysis was conducted on data from 70 patients, as the rest of the data either had artifact or there was a significant change in medication status. Electroencephalogram seizure duration was noted in each session for these patients. Results: Seizure duration declined significantly from second ECT to 6th ECT (repeated measures analysis of variance F = 4.255; P = 0.006). When separate analysis was conducted for BTECT and BFECT patients the decline in seizure duration from 2nd to 6th ECT was significant only with BFECT (F = 3.94; P = 0.014) and not with BTECT (F = 0.966; P = 0.424). Conclusions: Better anticonvulsant effects with BFECT may explain the better therapeutic observed with BFECT in schizophrenia as well as mania in our earlier studies. PMID:24701009

  10. MST with Conduct Disordered Youth in Sweden: Costs and Benefits after 2 Years

    ERIC Educational Resources Information Center

    Olsson, Tina M.

    2010-01-01

    Objectives: The purpose of this study was to investigate the costs and benefits associated with multisystemic therapy (MST) for conduct disordered youth, 2 years following intake. Methods: The study employed a secondary analysis of 156 youth enrolled in a randomized trial assessing the psychosocial and behavioral outcomes of MST. Results: MST cost…

  11. Evaluation of Cannabidiol in Animal Seizure Models by the Epilepsy Therapy Screening Program (ETSP).

    PubMed

    Klein, Brian D; Jacobson, Catherine A; Metcalf, Cameron S; Smith, Misty D; Wilcox, Karen S; Hampson, Aidan J; Kehne, John H

    2017-07-01

    Cannabidiol (CBD) is a cannabinoid component of marijuana that has no significant activity at cannabinoid receptors or psychoactive effects. There is considerable interest in CBD as a therapy for epilepsy. Almost a third of epilepsy patients are not adequately controlled by clinically available anti-seizure drugs (ASDs). Initial studies appear to demonstrate that CBD preparations may be a useful treatment for pharmacoresistant epilepsy. The National Institute of Neurological Disorders and Stroke (NINDS) funded Epilepsy Therapy Screening Program (ETSP) investigated CBD in a battery of seizure models using a refocused screening protocol aimed at identifying pharmacotherapies to address the unmet need in pharmacoresistant epilepsy. Applying this new screening workflow, CBD was investigated in mouse 6 Hz 44 mA, maximal electroshock (MES), corneal kindling models and rat MES and lamotrigine-resistant amygdala kindling models. Following intraperitoneal (i.p.) pretreatment, CBD produced dose-dependent protection in the acute seizure models; mouse 6 Hz 44 mA (ED50 164 mg/kg), mouse MES (ED50 83.5 mg/kg) and rat MES (ED50 88.9 mg/kg). In chronic models, CBD produced dose-dependent protection in the corneal kindled mouse (ED50 119 mg/kg) but CBD (up to 300 mg/kg) was not protective in the lamotrigine-resistant amygdala kindled rat. Motor impairment assessed in conjunction with the acute seizure models showed that CBD exerted seizure protection at non-impairing doses. The ETSP investigation demonstrates that CBD exhibits anti-seizure properties in acute seizure models and the corneal kindled mouse. However, further preclinical and clinical studies are needed to determine the potential for CBD to address the unmet needs in pharmacoresistant epilepsy.

  12. Possible induction of West syndrome by oxcarbazepine therapy in a patient with complex partial seizures.

    PubMed

    Veerapandiyan, Aravindhan; Singh, Piyush; Mikati, Mohamad A

    2012-03-01

    Oxcarbazepine has been reported to precipitate myoclonic, generalised tonic-clonic, absence, and complex partial seizures, and carbamazepine to precipitate absences, myoclonic seizures and spasms. Here, we report a one-year, six-month-old girl with complex partial seizures who developed infantile spasms, developmental regression, and hypsarrhythmia during the two weeks directly following initiation of oxcarbazepine (14 mg/kg/day). All of these resolved within a few days after discontinuation of this medication. Although we cannot rule out that the above association may have been coincidental, or that the improvement may have been due to concurrent therapy, this case raises the possibility that oxcarbazepine, like carbamazepine, may precipitate infantile spasms and West syndrome.

  13. Nonconvulsive seizures in electroconvulsive therapy: further evidence of differential neurophysiological aspects of bitemporal versus bifrontal electrode placement.

    PubMed

    Teman, Paul T; Perry, Candace Lynn; Ryan, Debra A; Rasmussen, Keith G

    2006-03-01

    In recent years, attention has been focused on the role of electrode placement in determining efficacy and cognitive side effects of electroconvulsive therapy (ECT). In particular, interest in bifrontal electrode placement has increased. Some evidence indicates differential therapeutic, cognitive, and neurophysiological aspects of bifrontal versus bitemporal ECT. Occasionally in ECT practice, electroencephalographic seizure activity is manifested in the absence of motor convulsive activity, a phenomenon termed nonconvulsive seizures. This probably indicates isolated prefrontal seizure activity in the absence of motor strip involvement. We reviewed our records and found that bifrontally treated patients had a significantly higher incidence of nonconvulsive seizures in ECT than did bitemporally treated patients. Seizure threshold was also higher among the bifrontal patients. We hypothesize that this provides further evidence of differential neurophysiology of seizures induced with these 2 electrode placements.

  14. Influence of anesthetic drugs and concurrent psychiatric medication on seizure adequacy during electroconvulsive therapy.

    PubMed

    Bundy, Bogata D; Hewer, Walter; Andres, Franz-Josef; Gass, Peter; Sartorius, Alexander

    2010-06-01

    Electroconvulsive therapy (ECT) is performed under anesthesia and muscle relaxation. Only well-generalized seizures seem to have the high "adequacy" or "quality" that have been claimed to reflect positive predictive power for the outcome of an ECT course. The induction of well-generalized seizures can be potentially influenced by several variables. One major variable is concurrent medication including anesthetic drugs, since most anesthetic drugs are potent anticonvulsives. We hypothesized a negative influence of anesthetics and benzodiazepines but a positive effect of antidepressants and antipsychotics concurrently applied during ECT on seizure adequacy. We included inpatients (n = 41) with a DSM-IV-diagnosed major depressive episode treated with ECT (411 ECT sessions) during a period of 20 months (May 2005 to December 2006) in an open label and noncontrolled study. A repeated measurement regression analysis was performed with 8 seizure adequacy parameters as dependent variables. We indirectly quantified narcotic agent influence with bispectral index monitoring. In contrast to the impact of psychiatric comedication, this measure of "depth of narcosis" prior stimulation turned out to influence most seizure adequacy parameters in a highly significant manner. Thus, we concluded that the anticonvulsive properties of narcotic agents have much higher influence than concomitant psychotropic medication. Our data support the view that a significant influence of concurrent psychotropic drugs on seizure adequacy markers is missing, especially when directly compared with other confounders like stimulation energy, age, and depth of narcosis. The latter suggests to further prove the idea that lighter anesthesia is indeed an important tool to get patients faster into remission. 2010 Physicians Postgraduate Press, Inc.

  15. The MST Radar Technique

    NASA Technical Reports Server (NTRS)

    Balsley, B. B.

    1985-01-01

    The past ten year have witnessed the development of a new radar technique to examine the structure and dynamics of the atmosphere between roughly 1 to 100 km on a continuous basis. The technique is known as the MST (for Mesosphere-Stratosphere-Troposphere) technique and is usable in all weather conditions, being unaffected by precipitation or cloud cover. MST radars make use of scattering from small scale structure in the atmospheric refractive index, with scales of the order of one-half the radar wavelength. Pertinent scale sizes for middle atmospheric studies typically range between a fraction of a meter and a few meters. The structure itself arises primarily from atmospheric turbulence. The technique is briefly described along with the meteorological parameters it measures.

  16. MST Filterability Tests

    SciTech Connect

    Poirier, M. R.; Burket, P. R.; Duignan, M. R.

    2015-03-12

    The Savannah River Site (SRS) is currently treating radioactive liquid waste with the Actinide Removal Process (ARP) and the Modular Caustic Side Solvent Extraction Unit (MCU). The low filter flux through the ARP has limited the rate at which radioactive liquid waste can be treated. Recent filter flux has averaged approximately 5 gallons per minute (gpm). Salt Batch 6 has had a lower processing rate and required frequent filter cleaning. Savannah River Remediation (SRR) has a desire to understand the causes of the low filter flux and to increase ARP/MCU throughput. In addition, at the time the testing started, SRR was assessing the impact of replacing the 0.1 micron filter with a 0.5 micron filter. This report describes testing of MST filterability to investigate the impact of filter pore size and MST particle size on filter flux and testing of filter enhancers to attempt to increase filter flux. The authors constructed a laboratory-scale crossflow filter apparatus with two crossflow filters operating in parallel. One filter was a 0.1 micron Mott sintered SS filter and the other was a 0.5 micron Mott sintered SS filter. The authors also constructed a dead-end filtration apparatus to conduct screening tests with potential filter aids and body feeds, referred to as filter enhancers. The original baseline for ARP was 5.6 M sodium salt solution with a free hydroxide concentration of approximately 1.7 M.3 ARP has been operating with a sodium concentration of approximately 6.4 M and a free hydroxide concentration of approximately 2.5 M. SRNL conducted tests varying the concentration of sodium and free hydroxide to determine whether those changes had a significant effect on filter flux. The feed slurries for the MST filterability tests were composed of simple salts (NaOH, NaNO2, and NaNO3) and MST (0.2 – 4.8 g/L). The feed slurry for the filter enhancer tests contained simulated salt batch 6 supernate, MST, and filter enhancers.

  17. M Current-Based Therapies for Nerve Agent Seizures

    DTIC Science & Technology

    2013-07-01

    0.8 h, n = 5, p > 0.05 compared to untreated animals, Figure 5B). In a previous study of neonatal SE induced by kainic acid-induced SE, 50 mg/kg...treatment per se could not treat PILO-induced ESE. Combination therapy with 10 mg/kg diazepam Since FLU administration in the neonatal SE study was...benign familial neonatal convulsions (BFNC), and reconstitution studies suggest that M-current is mediated by KCNQ2/KCNQ3 channels6-8. Mutations in

  18. Effect of the Addition of Ketamine to Sevoflurane Anesthesia on Seizure Duration in Electroconvulsive Therapy.

    PubMed

    Erdil, Feray; Ozgul, Ulku; Çolak, Cemil; Cumurcu, Birgul; Durmus, Mahmut

    2015-09-01

    We evaluated the effects of a subanesthetic dose of ketamine, which was administered as an adjunct to sevoflurane, on duration of seizure activity, hemodynamic profile, and recovery times during electroconvulsive therapy in patients with major depression. Patients were randomly allocated to a group receiving either sevoflurane-ketamine (group SK) or sevoflurane-saline (group SS). Sevoflurane was initiated in both groups at 8% for anesthesia induction until loss of consciousness was achieved, at which point it was discontinued. After loss of consciousness, ketamine was administered to the group SK in the form of a 0.5-mg/kg intravenous bolus. Patients in the group SS received saline in the same manner. Mean arterial pressure (MAP) and heart rate were recorded before anesthetic induction (T1); after anesthetic induction (T2); as well as 0, 1, 3, and 10 minutes after the seizure had ended (T3, T4, T5, and T6, respectively). Motor and electroencephalogram seizure durations were recorded. Motor and electroencephalogram seizure durations in the group SS were similar to those observed for the group SK. The heart rate increased significantly during T2 to T6 in both group SS and group SK compared with the baseline. The MAP increased in the group SS during the period between T3 and T6 as well as in the group SK during the same period compared with the baseline. The MAP increased more in the group SK, in comparison with the group SS, during T2 (P < 0.05). The addition of ketamine at subanesthetic doses, for the purposes of anesthetic induction with sevoflurane, yielded results similar to those in the control group in terms of both seizure duration and hemodynamic stability.

  19. Focal Electrically Administered Seizure Therapy (FEAST): A novel form of ECT illustrates the roles of current directionality, polarity, and electrode configuration in seizure induction

    PubMed Central

    Spellman, Timothy; Peterchev, Angel V.; Lisanby, Sarah H.

    2009-01-01

    Electroconvulsive therapy (ECT) is a mainstay in the treatment of severe, medication resistant depression. The antidepressant efficacy and cognitive side effects of ECT are influenced by the position of the electrodes on the head and by the degree to which the electrical stimulus exceeds the threshold for seizure induction. However, surprisingly little is known about the effects of other key electrical parameters such as current directionality, polarity, and electrode configuration. Understanding these relationships may inform the optimization of therapeutic interventions to improve their risk/benefit ratio. To elucidate these relationships, we evaluated a novel form of ECT (focal electrically administered seizure therapy, FEAST) that combines unidirectional stimulation, control of polarity, and an asymmetrical electrode configuration, and contrasted it with conventional ECT in a nonhuman primate model. Rhesus monkeys had their seizure thresholds determined on separate days with ECT conditions that crossed the factors of current directionality (unidirectional or bidirectional), electrode configuration (standard bilateral or FEAST (small anterior and large posterior electrode)), and polarity (assignment of anode and cathode in unidirectional stimulation). Ictal expression and post-ictal suppression were quantified via scalp EEG. Findings were replicated and extended in a second experiment with the same subjects. Seizures were induced in each of 75 trials, including 42 FEAST procedures. Seizure thresholds were lower with unidirectional than with bidirectional stimulation (p<0.0001), and lower in FEAST than in bilateral ECS (p=0.0294). Ictal power was greatest in posterior-anode unidirectional FEAST, and post-ictal suppression was strongest in anterior-anode FEAST (p=0.0008 and p=0.0024, respectively). EEG power was higher in the stimulated hemisphere in posterior-anode FEAST (p=0.0246), consistent with the anode being the site of strongest activation. These findings

  20. Overview of MST Research

    NASA Astrophysics Data System (ADS)

    Sarff, J. S.

    2016-10-01

    MST progress in advancing the RFP for (1) fusion plasma confinement with ohmic heating and minimal external magnetization, (2) predictive capability in toroidal confinement physics, and (3) basic plasma physics is summarized. Validation of key plasma models is a program priority. Programmable power supplies (PPS) are being developed to maximize inductive capability. Well-controlled flattops with current as low as 0.02 MA are produced with an existing PPS, and Ip <= 0.8 MA is anticipated with a second PPS under construction. The Lundquist number spans S =10(4 - 9) for 0.02-0.8 MA, allowing nonlinear MHD validation using NIMROD and DEBS at low S to be connected to highest S experiments. The PPS also enables MST tokamak operation for studying transients and runaway electron suppression with RMPs. Gyrokinetic modeling with GENE predicts unstable TEM in improved-confinement plasmas. Fluctuations are measured with TEM properties including a density-gradient threshold larger than for tokamak plasmas. Probe measurements hint that drift waves are also excited via the turbulent cascade in standard RFP plasmas. Turbulent energization of an electron tail occurs during sawtooth reconnection. New diagnostics are being developed to measure the energetic ion profile and transport from EP instabilities with NBI. Supported by US DoE and NSF.

  1. Early clinical experience with lacosamide as adjunctive therapy in patients with refractory focal epilepsy and nocturnal seizures.

    PubMed

    García-Morales, Irene; Delgado, Rafael Toledano; Falip, Mercé; Campos, Dulce; García, María Eugenia; Gil-Nagel, Antonio

    2011-12-01

    This retrospective study reports the early experience with lacosamide (LCM) as adjunctive therapy in Spanish patients with refractory focal epilepsy. Sixty patients (mean age 38.3 years, 54% women, mean epilepsy duration 27.2 years, mean seizure rate 9.7/month, and 28% with mainly nocturnal seizures) taking ≥2 antiepileptic drugs (mean 2.2) were included. LCM maintenance doses were 200, 300, 400, and 500mg/day in 31, 16, 10, and 3 patients, respectively. Patients were followed up for 13-24 months. Twenty-eight patients (47%) reported a ≥50% reduction in seizure frequency. A ≥50% reduction in seizure frequency was reported by 65% and 40% of patients in the nocturnal seizure and diurnal seizure subgroups, respectively (p>0.05). Of the 28 responders, 2 achieved stable periods of seizure freedom of 6 and 11 months after starting LCM. Twenty patients (33%) reported drug-related adverse events (AEs); the most common was dizziness (16 patients). LCM was withdrawn in 8 patients (13%). There were no serious AEs. These results support the efficacy and safety of adjunctive LCM in patients with partial-onset seizures. 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  2. Lacosamide adjunctive therapy for partial-onset seizures: a meta-analysis.

    PubMed

    Sawh, Sonja C; Newman, Jennifer J; Deshpande, Santosh; Jones, Philip M

    2013-01-01

    Background. The relative efficacy and safety of lacosamide as adjunctive therapy compared to other antiepileptic drugs has not been well established. Objective. To determine if lacosamide provides improved efficacy and safety, reduced length of hospital stay and improved quality of life compared with other anti-epileptic therapies for adults with partial-onset seizures. Data Sources. A systematic review of the medical literature using Medline (1946-Week 4, 2012), EMBASE (1980-Week 3, 2012), Cochrane Central Register of Controlled Trials (Issue 1 of 12, January 2012). Additional studies were identified (through to February 7, 2012) by searching bibliographies, the FDA drug approval files, clinical trial registries and major national and international neurology meeting abstracts. No restrictions on publication status or language were applied. Study Selection. Randomized controlled trials of lacosamide in adults with partial-onset seizures were included. Data Extraction. Study selection, extraction and risk of bias assessment were performed independently by two authors. Authors of studies were contacted for missing data. Data Synthesis. All pooled analyses used the random effects model. Results. Three trials (1311 patients) met inclusion criteria. Lacosamide increased the 50% responder rate compared to placebo (RR 1.68 [95% CI 1.36 to 2.08]; I(2) = 0%). Discontinuation due to adverse events was statistically significantly higher in the lacosamide arm (RR3.13 [95% CI 1.94 to 5.06]; I(2) = 0%). Individual adverse events (ataxia, dizziness, fatigue, and nausea) were also significantly higher in the lacosamide group. Limitations. All dosage arms from the included studies were pooled to make a single pair-wise comparison to placebo. Selective reporting of outcomes was found in all of the included RCTs. Conclusions. Lacosamide as adjunctive therapy in patients with partial-onset seizures increases the 50% responder rate but with significantly more adverse events compared to

  3. Budget impact analysis of adjunctive therapy with lacosamide for partial-onset epileptic seizures in Belgium.

    PubMed

    Simoens, Steven

    2011-01-01

    This study aims to compute the budget impact of lacosamide, a new adjunctive therapy for partial-onset seizures in epilepsy patients from 16 years of age who are uncontrolled and having previously used at least three anti-epileptic drugs from a Belgian healthcare payer perspective. The budget impact analysis compared the 'world with lacosamide' to the 'world without lacosamide' and calculated how a change in the mix of anti-epileptic drugs used to treat uncontrolled epilepsy would impact drug spending from 2008 to 2013. Data on the number of patients and on the market shares of anti-epileptic drugs were taken from Belgian sources and from the literature. Unit costs of anti-epileptic drugs originated from Belgian sources. The budget impact was calculated from two scenarios about the market uptake of lacosamide. The Belgian target population is expected to increase from 5333 patients in 2008 to 5522 patients in 2013. Assuming that the market share of lacosamide increases linearly over time and is taken evenly from all other anti-epileptic drugs (AEDs), the budget impact of adopting adjunctive therapy with lacosamide increases from €5249 (0.1% of reference drug budget) in 2008 to €242,700 (4.7% of reference drug budget) in 2013. Assuming that 10% of patients use standard AED therapy plus lacosamide, the budget impact of adopting adjunctive therapy with lacosamide is around €800,000-900,000 per year (or 16.7% of the reference drug budget). Adjunctive therapy with lacosamide would raise drug spending for this patient population by as much as 16.7% per year. However, this budget impact analysis did not consider the fact that lacosamide reduces costs of seizure management and withdrawal. The literature suggests that, if savings in other healthcare costs are taken into account, adjunctive therapy with lacosamide may be cost saving.

  4. Toward Evidence-Based Transport of Evidence-Based Treatments: MST as an Example

    ERIC Educational Resources Information Center

    Schoenwald, Sonja K.

    2008-01-01

    This article describes the journey toward evidence-based transport and implementation in usual care settings of Multisystemic Therapy (MST) for youth with drug abuse and behavioral problems (Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998). Research and experience informing the design of the MST transport strategy, progress in…

  5. Lacosamide: a review of its use as adjunctive therapy in the management of partial-onset seizures.

    PubMed

    Hoy, Sheridan M

    2013-12-01

    Lacosamide (Vimpat(®)) is a functionalized amino acid available orally (as a syrup or tablet) and as an intravenous infusion. It is believed to exert its antiepileptic effect by selectively enhancing the slow inactivation of voltage-gated sodium channels. Lacosamide is approved in several countries worldwide as an adjunctive therapy for the treatment of partial-onset seizures; however, prescribing regulations differ between countries. This article reviews the use of lacosamide as indicated in adults and adolescents (aged 16-18 years) in the EU, where it is approved in this patient population as an adjunctive therapy to other AEDs in the treatment of partial-onset seizures, with or without secondary generalization. In three randomized, double-blind, placebo-controlled, multicentre studies in adults and adolescents (aged 16-18 years) with partial-onset seizures, adjunctive therapy with oral lacosamide (administered for an initial titration period followed by 12 weeks' maintenance therapy) generally reduced the frequency of seizures to a significantly greater extent than placebo, with antiepileptic efficacy sustained following longer-term treatment (up to 8 years) in this patient population. Oral and intravenous lacosamide were generally well tolerated in clinical studies, with the majority of adverse events being mild or moderate in severity. Very common adverse reactions following adjunctive therapy with oral lacosamide included diplopia, dizziness, headache and nausea; the tolerability profile of intravenous lacosamide appeared consistent with that of oral lacosamide, although intravenous administration was associated with local adverse events, such as injection site discomfort or pain, irritation and erythema. Thus, oral and intravenous lacosamide as an adjunctive therapy to other AEDs provides a useful option in the treatment of patients with partial-onset seizures.

  6. Refractory epileptic seizures due to vitamin B6 deficiency in a patient with Parkinson's disease under duodopa® therapy.

    PubMed

    Skodda, Sabine; Müller, Thomas

    2013-02-01

    Levodopa/carbidopa intestinal gel (LCIG) infusion for the treatment of advanced Parkinson's disease (PD) has been suspected to provoke polyneuropathy in conjunction with vitamin B6, B12 and folate deficiency and elevated homocysteine levels. We describe a PD patient under LCIG therapy developing refractory epileptic seizures obviously promoted by vitamin B6 deficiency.

  7. MST kinases in development and disease

    PubMed Central

    2015-01-01

    The mammalian MST kinase family, which is related to the Hippo kinase in Drosophila melanogaster, includes five related proteins: MST1 (also called STK4), MST2 (also called STK3), MST3 (also called STK24), MST4, and YSK1 (also called STK25 or SOK1). MST kinases are emerging as key signaling molecules that influence cell proliferation, organ size, cell migration, and cell polarity. Here we review the regulation and function of these kinases in normal physiology and pathologies, including cancer, endothelial malformations, and autoimmune disease. PMID:26370497

  8. Management of a First Seizure.

    PubMed

    Bergey, Gregory K

    2016-02-01

    Assessment of the patient with a first seizure is a common and important neurologic issue. Less than 50% of patients who have a first unprovoked seizure have a second seizure; thus, the evaluation should focus on determining the patient's risk of seizure recurrence. A number of population studies, including some classic reports, have identified the relative risk factors for subsequent seizure recurrence. The 2014 update of the International League Against Epilepsy definition of epilepsy incorporates these findings, and in 2015, the American Academy of Neurology published a guideline that analyzed the available data. Provoked or acute symptomatic seizures do not confer increased risk for subsequent unprovoked seizure recurrence. Multiple seizures in a given 24-hour period do not increase the risk of seizure recurrence. Remote symptomatic seizures, an epileptiform EEG, a significant brain imaging abnormality, and nocturnal seizures are risk factors for seizure recurrence. Antiepileptic drug therapy delays the time to second seizure but may not influence long-term remission.

  9. RADIUM AND THORIUM SORPTION BY MONOSODIUM TITANATE (MST) AND MODIFIED MST (mMST)

    SciTech Connect

    Taylor-Pashow, K.; Hobbs, D.

    2012-02-15

    A series of tests were planned to examine the removal of Ra and Th by monosodium titanate (MST) and modified monosodium titanate (mMST). Simulated waste solutions were prepared containing Ra and Th, along with Sr, Np, Pu, and U. Following simulant preparation the simulants were filtered through 0.45-m filters. Analysis of the simulants indicated no Th in the filtered solution. This is due to the very low solubility of Th in alkaline solutions. Based on the reported detection limits for {sup 228}Th by gamma analyses, the solubility of Th in the simulant solutions is < 3.0E-10 g/L or < 1.3E-12 M. Therefore, data could not be obtained regarding the removal of Th by MST and mMST; however, testing proceeded to examine the removal of Ra. Sorption testing indicated that Ra, like Sr, is very rapidly removed from solution by both MST and mMST. The Ra concentration in solution fell below the method detection limit (MDL) within 30 minutes of contact with MST, and within 2 hours of contact with mMST, when tested at 25 C using a 5.6 M Na simulant. Additional testing examined the effects of ionic strength and temperature on the MST and mMST performance. Results from these tests showed that the majority of samples still reached a Ra concentration below the MDL, indicating excellent removal. For the highest ionic strength solution (6.6 M Na), there did appear to be a slight decrease in the Ra removal by mMST, as indicated by a larger number of samples just above the MDL. The effect of temperature on {sup 226}Ra removal is indeterminate for either MST or mMST in the temperature range (25-60 C) and concentrations studied since the final soluble concentration of Ra remained at or below the detection limits for all tests. Desorption testing was also performed using decontaminated salt solution (DSS) diluted to sodium concentrations of 2 M and 0.5 M, to represent the intermediate and final stages of washing. Results from these tests indicated no desorption of any sorbents, with the

  10. Methylxanthines, seizures, and excitotoxicity.

    PubMed

    Boison, Detlev

    2011-01-01

    Clinical evidence, in particular the wide use of theophylline as a bronchodilator, suggests that methylxanthines can cause seizures in patients without known underlying epilepsy. Theophylline is also known to be an added risk factor for seizure exacerbation in patients with epilepsy. The proconvulsant activity of methylxanthines can best be explained by their antagonizing the brain's own anticonvulsant adenosine. Recent evidence suggests that adenosine dysfunction is a pathological hallmark of epilepsy contributing to seizure generation and seizure spread. Conversely, adenosine augmentation therapies are effective in seizure suppression and prevention, whereas adenosine receptor antagonists such as methylxanthines generally exacerbate seizures. The impact of the methylxanthines caffeine and theophylline on seizures and excitotoxicity depends on timing, dose, and acute versus chronic use. New findings suggest a role of free radicals in theophylline-induced seizures, and adenosine-independent mechanisms for seizure generation have been proposed.

  11. AANA Journal course: update for nurse anesthetists--anesthetic management during electroconvulsive therapy: effects on seizure duration and antidepressant efficacy.

    PubMed

    Hick, E M; Black, J L

    1999-02-01

    Electroconvulsive therapy (ECT) is an effective treatment for some types of depression and psychotic disorders. Although ECT is considered effective and relatively safe, the treatment team must know how to deal with adverse effects. The American Psychiatric Association recognizes no absolute contraindication except brain tumor with increased intracranial pressure. However, patients who have other medical problems are at risk of complications. Optimizing the safety and efficacy of treatment is a goal when providing ECT. Muscle relaxants, barbiturate anesthesia, anticholinergic agents, and oxygenation are used to reduce the risk of complications. The use of ECT requires a knowledge of the effect of anesthetic agents on seizure activity. This article reviews ECT, anesthesia for ECT, and the effect of propofol and methohexital on seizure duration and seizure efficacy.

  12. The effects of vagus nerve stimulation therapy on patients with intractable seizures and either Landau-Kleffner syndrome or autism.

    PubMed

    Park, Yong D

    2003-06-01

    Acquired and developmental comorbid conditions, including language and behavioral disorders, are often associated with epilepsy. Although the relationship between these disorders is not fully understood, their close association may indicate that they share common features, suggesting that these conditions may respond to the same therapies. Not only has vagus nerve stimulation (VNS) therapy been proven to reduce the frequency of pharmacoresistant seizures in epilepsy patients, but preliminary studies also indicate that VNS therapy may improve neurocognitive performance. On the basis of these findings, we hypothesized that VNS therapy would improve the quality of life of patients with either Landau-Kleffner syndrome (LKS) or autism, independent of its effects on seizures. Data were retrospectively queried from the VNS therapy patient outcome registry (Cyberonics, Inc; Houston, TX, USA). A constant cohort of 6 LKS patients and 59 autistic patients were identified. Among the LKS patients, 3 patients at 6 months experienced at least a 50% reduction in seizure frequency as compared with baseline. Physicians reported quality-of-life improvements in all areas assessed for at least 3 of the 6 children. More than half of the patients with autism (58%) experienced at least a 50% reduction in seizure frequency at 12 months. Improvements in all areas of quality of life monitored were reported for most patients, particularly for alertness (76% at 12 months). Although these preliminary findings are encouraging, a prospective study using standardized measurement tools specific to these disorders and a longer-term follow-up are necessary to better gauge the efficacy of VNS therapy among these patient populations.

  13. MET and MST1R as prognostic factors for classical Hodgkin's lymphoma.

    PubMed

    Wha Koh, Young; Park, Chansik; Hyun Yoon, Dok; Suh, Cheolwon; Huh, Jooryung

    2013-09-01

    MST1R (RON) and MET are receptor tyrosine kinase gene family members that form a noncovalent complex on the cell surface, a critical step in tumor progression. A recent study suggested a prognostic role of MET expression in Hodgkin/Reed-Sternberg (HRS) cells in classical Hodgkin's lymphoma (cHL). The purpose of this study was to examine the prognostic significance of MET and MST1R expression in cHL. The prognostic impact of MET and MST1R was examined in 100 patients with cHL (median age: 32 years) by immunohistochemistry and mRNA in situ hybridization. The median follow-up time was 95 months (interquartile range: 42-126 months). MET or MST1R protein expression was associated with high MET or MST1R mRNA expression, respectively. Thirty-eight patients (38%) expressed MET protein in HRS cell, which was associated with better overall survival (P=0.004). Twenty-six patients (26%) expressed MST1R protein, which was associated with better overall survival (P=0.022) and event-free survival (P=0.021). Multivariate analysis identified MET protein as an independent prognostic factor for overall survival and MST1R protein as an independent prognostic factor for event-free survival. Subgroup analysis according to Ann Arbor stage showed that expressions of MET and MST1R protein have prognostic impact in the advanced stage only. In particular, coexpression of MST1R and MET protein was associated with a better survival outcome than MET or MST1R expression alone or no expression. This study suggests that MET and MST1R are independent prognostic factors in classical cHL, and may allow the identification of a subgroup of cHL patients who require more intensive therapy.

  14. Caramiphen edisylate as adjunct to standard therapy attenuates soman-induced seizures and cognitive deficits in rats.

    PubMed

    Schultz, M K; Wright, L K M; de Araujo Furtado, M; Stone, M F; Moffett, M C; Kelley, N R; Bourne, A R; Lumeh, W Z; Schultz, C R; Schwartz, J E; Lumley, L A

    2014-01-01

    The progression of epileptiform activity following soman (GD) exposure is characterized by a period of excessive cholinergic activity followed by excessive glutamatergic activity resulting in status epilepticus, which may lead to neuropathological damage and behavioral deficits. Caramiphen edisylate is an anticholinergic drug with antiglutamatergic properties, which conceptually may be a beneficial therapeutic approach to the treatment of nerve agent exposure. In the present study, rats were exposed to 1.2 LD50 GD or saline, treated with atropine sulfate (2mg/kg, im) and HI-6 (93.6mg/kg, im) 1min after GD exposure, and monitored for seizure activity. Rats were treated with diazepam (10mg/kg, sc) and caramiphen (0, 20 or 100mg/kg, im) 30min after seizure onset. Following GD exposure, performance was evaluated using a battery of behavioral tests to assess motor coordination and function, sensorimotor gating, and cognitive function. Caramiphen as adjunct to diazepam treatment attenuated GD-induced seizure activity, neuropathological damage, and cognitive deficits compared to diazepam alone, but did not attenuate the GD-induced sensorimotor gating impairment. These findings show that physiological, behavioral, and neuropathological effects of GD exposure can be attenuated by treatment with caramiphen as an adjunct to therapy, even if administration is delayed to 30min after seizure onset. Published by Elsevier Inc.

  15. Absence seizure

    MedlinePlus

    Seizure - petit mal; Seizure - absence; Petit mal seizure; Epilepsy - absence seizure ... Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff ... Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 101. ...

  16. MST-80B microcomputer trainer

    SciTech Connect

    Jones, G.D.; Fisher, E.R.; Spann, J.M.

    1980-04-01

    The microcomputer revolution in electronics is spreading so rapidly that it is difficult to educate enough people quickly and thoroughly in the new technology. Lawrence Livermore Laboratory's MST-80B was developed as a way to speed learning in in-house training courses, and it is now being widely used outside LLL. The MST-80B trainer is a complete, self-contained, microcomputer system housed in a briefcase. The trainer uses the Intel 8080A 8-Bit Microprocessor (CPU), and it has its own solid-state memory, a built-in keyboard, input and output ports, and a display for visual output. The trainer is furnished with a permanent Monitor Program (in Read-Only Memory) that allows users to enter, debug, modify, and run programs of their own easily. 8 figures, 3 tables.

  17. Expanded Safety and Efficacy Data for a New Method of Performing Electroconvulsive Therapy: Focal Electrically Administered Seizure Therapy.

    PubMed

    Sahlem, Gregory L; Short, E Baron; Kerns, Suzanne; Snipes, Jon; DeVries, William; Fox, James B; Burns, Carol; Schmidt, Matthew; Nahas, Ziad H; George, Mark S; Sackeim, Harold A

    2016-09-01

    Electroconvulsive therapy (ECT) is the most rapid and effective antidepressant treatment but with concerns about cognitive adverse effects. A new form of ECT, focal electrically administered seizure therapy (FEAST), was designed to increase the focality of stimulation and better match stimulus parameters with neurophysiology. We recently reported on the safety and feasibility of FEAST in a cohort (n = 17) of depressed patients. We now report on the safety, feasibility, preliminary efficacy, and cognitive effects of FEAST in a new cohort. Open-label FEAST was administered to 20 depressed adults (6 men; 3 with bipolar disorder; age 49.1 ± 10.6 years). Clinical and cognitive assessments were obtained at baseline and end of course. Time to orientation recovery was assessed at each treatment. Nonresponders switched to conventional ECT. Participants tolerated the treatment well with no dropouts. Five patients (25%) transitioned from FEAST to conventional ECT due to inadequate response. After FEAST (mean, 9.3 ± 3.5 sessions; range, 4-14), there was a 58.1% ± 36.0% improvement in Hamilton Rating Scale for Depression scores compared with that in the baseline (P < 0.0001); 13 (65%) of 20 patients met response criteria, and 11 (55%) of 20 met remission criteria. Patients achieved reorientation (4 of 5 items) in 4.4 ± 3.0 minutes (median, 4.5 minutes), timed from eyes opening. There was no deterioration in neuropsychological measures. These findings provide further support for the safety and efficacy of FEAST. The remission and response rates were in the range found using conventional ECT, and the time to reorientation may be quicker. However, without a randomized comparison group, conclusions are tentative.

  18. Therapy for hyperthermia-induced seizures in Scn1a mutant rats.

    PubMed

    Hayashi, Keiichiro; Ueshima, Satoshi; Ouchida, Mamoru; Mashimo, Tomoji; Nishiki, Teiichi; Sendo, Toshiaki; Serikawa, Tadao; Matsui, Hideki; Ohmori, Iori

    2011-05-01

    Mutations in the SCN1A gene, which encodes the α1 subunit of voltage-gated sodium channels, cause generalized epilepsy with febrile seizures plus (GEFS+) and severe myoclonic epilepsy of infancy (SMEI). N1417H-Scn1a mutant rats are considered to be an animal model of human FS+ or GEFS+. To assess the pharmacologic validity of this model, we compared the efficacies of eight different antiepileptic drugs (AEDs) for the treatment of hyperthermia-induced seizures using N1417H-Scn1a mutant rats. AEDs used in this study included valproate, carbamazepine (CBZ), phenobarbital, gabapentin, acetazolamide, diazepam (DZP), topiramate, and potassium bromide (KBr). The effects of these AEDs were evaluated using the hot water model, which is a model of experimental FS. Five-week-old rats were pretreated with each AED and immersed in water at 45°C to induce hyperthermia-induced seizures. The seizure manifestations and video-electroencephalographic recordings were evaluated. Furthermore, the effects of each AED on motor coordination and balance were assessed using the balance-beam test. KBr significantly reduced seizure durations, and its anticonvulsant effects were comparable to those of DZP. On the other hand, CBZ decreased the seizure threshold. In addition, DZP and not KBr showed significant impairment in motor coordination and balance. DZP and KBr showed potent inhibitory effects against hyperthermia-induced seizures in the Scn1a mutant rats, whereas CBZ exhibited adverse effects. These responses to hyperthermia-induced seizures were similar to those in patients with GEFS+ and SMEI. N1417H-Scn1a mutant rats may, therefore, be useful for testing the efficacy of new AEDs against FS in GEFS+ and SMEI patients. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  19. Low glycemic index treatment for seizure control in Angelman syndrome: A case series from the Center for Dietary Therapy of Epilepsy at the Massachusetts General Hospital.

    PubMed

    Grocott, Olivia R; Herrington, Katherine S; Pfeifer, Heidi H; Thiele, Elizabeth A; Thibert, Ronald L

    2017-03-01

    The low glycemic index treatment, a dietary therapy that focuses on glycemic index and reduced carbohydrate intake, has been successful in reducing seizure frequency in the general epilepsy population. Epilepsy is a common feature of Angelman syndrome and seizures are often refractory to multiple medications, especially in those with maternal deletions. Dietary therapy has become a more frequently used option for treating epilepsy, often in combination with other antiepileptic drugs, due to its efficacy and favorable side effect profile. This study aimed to assess the effectiveness of the low glycemic index treatment for seizure control in Angelman syndrome. Through a retrospective medical record review of 23 subjects who utilized the low glycemic index treatment at the Clinic and Center for Dietary Therapy of Epilepsy at the Massachusetts General Hospital, we found that the high level of seizure control and favorable side effect profile make the low glycemic index treatment a viable treatment for seizures in Angelman syndrome. The majority of subjects in our cohort experienced some level of seizure reduction after initiating the diet, 5 (22%) maintained complete seizure freedom, 10 (43%) maintained seizure freedom except in the setting of illness or non-convulsive status epilepticus, 7 (30%) had a decrease in seizure frequency, and only 1 (4%) did not have enough information to determine seizure control post-initiation. The low glycemic index treatment monotherapy was successful for some subjects in our cohort but most subjects used an antiepileptic drug concurrently. Some subjects were able to maintain the same level of seizure control on a liberalized version of the low glycemic index treatment which included a larger amount of low glycemic carbohydrates. No correlation between the level of carbohydrate restriction and level of seizure control was found. Few subjects experienced side effects and those that did found them to be mild and easily treated. The

  20. Changes in Maternal Depression Are Associated with MST Outcomes for Adolescents with Co-Occurring Externalizing and Internalizing Problems

    ERIC Educational Resources Information Center

    Grimbos, Teresa; Granic, Isabela

    2009-01-01

    The efficacy of Multisystemic therapy (MST) in treating adolescent aggression has been established, however, not all youth and their families benefit from MST. One reason for this treatment variability could be the failure to distinguish between different aggressive subtypes with different risk factors, developmental prognoses and treatment needs.…

  1. MST radar detection of middle atmosphere tides

    NASA Technical Reports Server (NTRS)

    Forbes, J. M.

    1983-01-01

    Meteorological and dynamical requirements pertaining to the specification of middle atmosphere tides by the MST radar technique are outlined. Major issues addressed include: (1) the extraction of tidal information from measurements covering a fraction of a day; (2) the ramifications of transient effects (tidal variability) on the determination and interpretation of tides; (3) required temporal and spatial resolutions and; (4) global distributions of MST radars, so as to complement existing MST, meteor wind, and partial reflection drift radar locations.

  2. Vagus nerve stimulation therapy for partial-onset seizures: a randomized active-control trial.

    PubMed

    Handforth, A; DeGiorgio, C M; Schachter, S C; Uthman, B M; Naritoku, D K; Tecoma, E S; Henry, T R; Collins, S D; Vaughn, B V; Gilmartin, R C; Labar, D R; Morris, G L; Salinsky, M C; Osorio, I; Ristanovic, R K; Labiner, D M; Jones, J C; Murphy, J V; Ney, G C; Wheless, J W

    1998-07-01

    The purpose of this multicenter, add-on, double-blind, randomized, active-control study was to compare the efficacy and safety of presumably therapeutic (high) vagus nerve stimulation with less (low) stimulation. Chronic intermittent left vagus nerve stimulation has been shown in animal models and in preliminary clinical trials to suppress the occurrence of seizures. Patients had at least six partial-onset seizures over 30 days involving complex partial or secondarily generalized seizures. Concurrent antiepileptic drugs were unaltered. After a 3-month baseline, patients were surgically implanted with stimulating leads coiled around the left vagus nerve and connected to an infraclavicular subcutaneous programmable pacemaker-like generator. After randomization, device initiation, and a 2-week ramp-up period, patients were assessed for seizure counts and safety over 3 months. The primary efficacy variable was the percentage change in total seizure frequency compared with baseline. Patients receiving high stimulation (94 patients, ages 13 to 54 years) had an average 28% reduction in total seizure frequency compared with a 15% reduction in the low stimulation group (102 patients, ages 15 to 60 year; p = 0.04). The high-stimulation group also had greater improvements on global evaluation scores, as rated by a blinded interviewer and the patient. High stimulation was associated with more voice alteration and dyspnea. No changes in physiologic indicators of gastric, cardiac, or pulmonary functions occurred. Vagus nerve stimulation is an effective and safe adjunctive treatment for patients with refractory partial-onset seizures. It represents the advent of a new, nonpharmacologic treatment for epilepsy.

  3. 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

  4. Risk factors and the outcome of therapy in patients with seizure after Carbamazepine poisoning: A two-year cross-sectional study

    PubMed Central

    Yaraghi, Ahmad; Eizadi-Mood, Nastaran; Salehi, Marzieh; Massoumi, Gholamreza; Zunic, Lejla; Sabzghabaee, Ali Mohammad

    2015-01-01

    Objective: We aimed to investigate the frequency of seizure after acute carbamazepine poisoning and the important risk factors related to the outcomes of therapy. Methods: In this two-year cross-sectional study conducted in a University Hospital in Iran, 114 patients with acute carbamazepine poisoning were divided into two groups of with seizure (n = 8) and without seizure (n = 106) after intoxication. Demographic data, average amount of drug ingestion, time elapsed from ingestion to hospital admission, history of seizure before poisoning, mental status, visual disturbances and nystagmus, duration of hospitalization, the outcomes of therapy, arterial blood gas values and serum biochemical indices were compared between the two groups. Findings: Patients with seizure had an estimated (Mean ± SD) ingestion of 14,300 ± 570 mg carbamazepine, which was significantly higher (P < 0.0001) than the seizure-free group (4600 ± 420 mg). The estimated average time between drug ingestion and hospital admission in patients with seizure and the seizure-free group were 515 ± 275 and 370 ± 46 minutes, respectively (P < 0.0001). In this study, 104 out of the total number of patients had recovered without any complication. Need for respiratory support, including airway support or intubation were the most recorded complication. One patient died after status epilepticus and aspiration pneumonia. Conclusion: The ingested amount of carbamazepine and the time elapsed from the ingestion of drug to hospital admission may influence the occurrence of seizure after acute carbamazepine poisoning; however, the outcome of supportive care in these patients seems to be positive. PMID:25710046

  5. AWIWPCA STATES HELPING STATES CLL ON MST

    EPA Science Inventory

    Several Microbial Source Tracking (MST) tools are now being applied in the development of TMDL plans and in the evaluation of best management practices. However, due to the relatively recent development of MST most environmental managers and scientists have little training and ...

  6. Jet stream related observations by MST radars

    NASA Technical Reports Server (NTRS)

    Gage, K. S.

    1983-01-01

    An overview of the jet stream and its observation by MST radar is presented. The climatology and synoptic and mesoscale structure of jet streams is briefly reviewed. MST radar observations of jet stream winds, and associated waves and turbulence are then considered. The possibility of using a network of ST radars to track jet stream winds in near real time is explored.

  7. Pharmacological therapies against soman-induced seizures in rats 30 min following onset and anticonvulsant impact.

    PubMed

    Myhrer, Trond; Enger, Siri; Aas, Pål

    2006-10-24

    Systemic administration does not allow a clear differentiation between the anticonvulsant properties of GABAA (gamma-aminobutyric acid) modulators. For this reason, various GABAA modulators have previously been micro-infused into seizure controlling substrates (area tempestas, substantia nigra) in the rat brain as a screening method for potential systemic administration. The purpose of the present study was to examine the anticonvulsant impact of the GABAergic modulators muscimol, ethanol, and propofol (screened by micro-infusions) when each drug was combined with procyclidine and administered systemically. The results showed that all 3 combinations could effectively terminate soman-induced (100 microg/kg s.c.) seizures when administered 30-35 min after onset. Procyclidine and propofol were considered as the most relevant double regimen to replace a previous triple regimen (procyclidine, diazepam, pentobarbital) against soman-induced seizures. Additionally, it was shown that unilateral implantation of hippocampal electrodes resulted in increased resistance to aphagia/adipsia and neuropathology, but not to lethality following soman. Efficient pharmacological treatment of soman-induced seizures at an early stage (< 20 min) is crucial to avoid neuropathology and cognitive deficits.

  8. 10 Methylxanthines, seizures and excitotoxicity

    PubMed Central

    Boison, Detlev

    2010-01-01

    Clinical evidence, in particular the wide use of theophylline as bronchodilator, suggests that methylxanthines can cause seizures in patients without known underlying epilepsy. Theophylline is also known to be an added risk factor for seizure exacerbation in patients with epilepsy. The proconvulsant activity of methylxanthines can best be explained by antagonizing the brain’s own anticonvulsant adenosine. Recent evidence suggests that adenosine dysfunction is a pathological hallmark of epilepsy contributing to seizure generation and seizure spread. Conversely, adenosine augmentation therapies are effective in seizure suppression and prevention, whereas adenosine receptor antagonists such as methylxanthines generally exacerbate seizures. The impact of the methylxanthines caffeine and theophylline on seizures and excitotoxicity depends on timing, dose, and acute versus chronic use. New findings suggest a role of free radicals in theophylline-induced seizures and adenosine-independent mechanisms for seizure generation have been proposed. PMID:20859799

  9. The effects of adjunctive topiramate therapy on seizure severity and health-related quality of life in patients with refractory epilepsy---a Canadian study.

    PubMed

    Baker, Gus A; Currie, Natalie G T; Light, Margaret J; Schneiderman, Jack H

    2002-01-01

    Although reduction in seizure frequency is the most common endpoint used to assess the antiepileptic efficacy, seizure frequency alone does not provide a complete picture of effectiveness, particularly in patients with refractory epilepsy. The aim of our study was to assess the effects of topiramate on seizure severity and health-related quality of life (HRQL), in addition to standard efficacy measures, in an open, multicentre, 6-month trial of patients with epilepsy uncontrolled on antiepileptic drugs other than topiramate. Two hundred and nine patients were enrolled and received topiramate for up to 6 months (initiated at 50 mg/day and titrated to a recommended dose of 200-400 mg/day) in addition to existing medication. The median reduction in seizure frequency from baseline to the post-titration period was 40.9% ( P< 0.0001). Patients also demonstrated a mean reduction in the Liverpool Seizure Severity Scale (LSSS) of 5.3 ( P< 0.0001), which was considered clinically significant. Statistically significant changes in HRQL were not observed with the SF-36, a generic measure. Tolerability of antiepileptic medication was good, with a low incidence of cognitive adverse events. The results indicate that topiramate significantly reduces seizure severity---an important aspect of HRQL---when administered as adjunctive therapy to anticonvulsant therapy.

  10. Review of levetiracetam, with a focus on the extended release formulation, as adjuvant therapy in controlling partial-onset seizures

    PubMed Central

    Ulloa, Carol M; Towfigh, Allen; Safdieh, Joseph

    2009-01-01

    Levetiracetam is a second-generation antiepileptic drug (AED) with a unique chemical structure and mechanism of action. The extended release formulation of levetiracetam (Keppra XR™; UCB Pharma) was recently approved by the Food and Drug Administration for adjunctive therapy in the treatment of partial-onset seizures in patients 16 years of age and older with epilepsy. This approval is based on a double-blind, randomized, placebo-controlled, multicenter, multinational trial. Levetiracetam XR allows for once-daily dosing, which may increase compliance and, given the relatively constant plasma concentrations, may minimize concentration-related adverse effects. Levetiracetam’s mode of action is not fully elucidated, but it has been found to target high-voltage, N-type calcium channels as well as the synaptic vesicle protein 2A (SV2A). Levetiracetam has nearly ideal pharmacokinetics. It is rapidly and almost completely absorbed after oral ingestion, is <10% protein-bound, demonstrates linear kinetics, is minimally metabolized through a pathway independent of the cytochrome P450 system, has no significant drug–drug interactions, and has a wide therapeutic index. The most common reported adverse events with levetiracetam XR were somnolence, irritability, dizziness, nausea, influenza, and nasopharyngitis. Levetiracetam XR provides an efficacious and well-tolerated treatment option for adjunctive therapy in the treatment of partial-onset seizures. PMID:19777068

  11. Absence Seizure (Petit Mal Seizure)

    MedlinePlus

    ... Staff Absence seizures involve brief, sudden lapses of consciousness. They're more common in children than adults. ... have seizures, the brain's usual electrical activity is altered. During an absence seizure, these electrical signals repeat ...

  12. AMPA GluA1-flip targeted oligonucleotide therapy reduces neonatal seizures and hyperexcitability

    PubMed Central

    Lykens, Nicole M.; Reddi, Jyoti M.

    2017-01-01

    Glutamate-activated α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPA-Rs) mediate the majority of excitatory neurotransmission in brain and thus are major drug targets for diseases associated with hyperexcitability or neurotoxicity. Due to the critical nature of AMPA-Rs in normal brain function, typical AMPA-R antagonists have deleterious effects on cognition and motor function, highlighting the need for more precise modulators. A dramatic increase in the flip isoform of alternatively spliced AMPA-R GluA1 subunits occurs post-seizure in humans and animal models. GluA1-flip produces higher gain AMPA channels than GluA1-flop, increasing network excitability and seizure susceptibility. Splice modulating oligonucleotides (SMOs) bind to pre-mRNA to influence alternative splicing, a strategy that can be exploited to develop more selective drugs across therapeutic areas. We developed a novel SMO, GR1, which potently and specifically decreased GluA1-flip expression throughout the brain of neonatal mice lasting at least 60 days after single intracerebroventricular injection. GR1 treatment reduced AMPA-R mediated excitatory postsynaptic currents at hippocampal CA1 synapses, without affecting long-term potentiation or long-term depression, cellular models of memory, or impairing GluA1-dependent cognition or motor function in mice. Importantly, GR1 demonstrated anti-seizure properties and reduced post-seizure hyperexcitability in neonatal mice, highlighting its drug candidate potential for treating epilepsies and other neurological diseases involving network hyperexcitability. PMID:28178321

  13. AMPA GluA1-flip targeted oligonucleotide therapy reduces neonatal seizures and hyperexcitability.

    PubMed

    Lykens, Nicole M; Coughlin, David J; Reddi, Jyoti M; Lutz, Gordon J; Tallent, Melanie K

    2017-01-01

    Glutamate-activated α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPA-Rs) mediate the majority of excitatory neurotransmission in brain and thus are major drug targets for diseases associated with hyperexcitability or neurotoxicity. Due to the critical nature of AMPA-Rs in normal brain function, typical AMPA-R antagonists have deleterious effects on cognition and motor function, highlighting the need for more precise modulators. A dramatic increase in the flip isoform of alternatively spliced AMPA-R GluA1 subunits occurs post-seizure in humans and animal models. GluA1-flip produces higher gain AMPA channels than GluA1-flop, increasing network excitability and seizure susceptibility. Splice modulating oligonucleotides (SMOs) bind to pre-mRNA to influence alternative splicing, a strategy that can be exploited to develop more selective drugs across therapeutic areas. We developed a novel SMO, GR1, which potently and specifically decreased GluA1-flip expression throughout the brain of neonatal mice lasting at least 60 days after single intracerebroventricular injection. GR1 treatment reduced AMPA-R mediated excitatory postsynaptic currents at hippocampal CA1 synapses, without affecting long-term potentiation or long-term depression, cellular models of memory, or impairing GluA1-dependent cognition or motor function in mice. Importantly, GR1 demonstrated anti-seizure properties and reduced post-seizure hyperexcitability in neonatal mice, highlighting its drug candidate potential for treating epilepsies and other neurological diseases involving network hyperexcitability.

  14. Improving collaboration: a qualitative assessment of inter-agency collaboration between a pilot Multisystemic Therapy Child Abuse and Neglect (MST-CAN) program and a child protection team.

    PubMed

    Hebert, Sarah; Bor, William; Swenson, Cynthia C; Boyle, Christopher

    2014-08-01

    Child protection inter-agency collaboration is characterized by strengths and problems. Some literature notes positive attitudes and high trust between teams. However, difficulties with communication, confidentiality, roles, boundaries and divergent paradigms reconciling child protection and parent mental health needs have been documented. This study investigated whether a pilot model of intensive family intervention for maltreated children and associated intensive inter-agency cooperation delivered an effective collaboration. At the completion of the pilot program, a child protection team was interviewed. A qualitative assessment by semi-structured group interview format of inter-agency collaboration was undertaken and evaluated by a thematic analysis. The analysis identified: strong endorsement of the collaborative model; no changes in perception of referred patients; changes in treatment approaches. No perceived conflict between child protection and parent mental health needs were noted. The changes noted may be due to the unique structure and functioning of the pilot Multisystemic Therapy Child Abuse and Neglect program, which encouraged high levels of team communication, strong client engagement, availability and intensive treatment of child and parent mental health problems. The implications for future collaborations are discussed as well as limitations of the study. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  15. Prolonged exposure therapy for the treatment of patients diagnosed with psychogenic non-epileptic seizures (PNES) and post-traumatic stress disorder (PTSD).

    PubMed

    Myers, Lorna; Vaidya-Mathur, Urmi; Lancman, Marcelo

    2017-01-01

    Although there is general consensus that psychogenic non-epileptic seizures (PNES) are treated with psychotherapy, the effectiveness of most psychotherapeutic modalities remains understudied. In this treatment series of 16 patients dually diagnosed with PNES and post-traumatic stress disorder (PTSD), we evaluated the effect of prolonged exposure therapy (PE) on reduction of PNES. Secondary measures included Beck Depression Inventory (BDI-II) and Post-Traumatic Disorder Diagnostic Scale (PDS). Subjects diagnosed with video EEG-confirmed PNES and PTSD confirmed through neuropsychological testing and clinical interview were treated with traditional PE psychotherapy with certain modifications for the PNES. Treatment was conducted over the course of 12-15 weekly sessions. Seizure frequency was noted in each session by examining the patients' seizure logs, and mood and PTSD symptomatology was assessed at baseline and on the final session. Eighteen subjects enrolled, and 16 (88.8%) completed the course of treatment. Thirteen of the 16 (81.25%) therapy completers reported no seizures by their final PE session, and the other three reported a decline in seizure frequency (Z=-3.233, p=0.001). Mean scores on scales of depression (M=-13.56, SD=12.27; t (15)=-4.420, p<0,001) and PTSD symptoms (M=-17.1875, SD=13.01; t (15)=-5.281, p<0.001) showed significant improvement from baseline to final session. Longitudinal seizure follow up in 14 patients revealed that gains made on the final session were maintained at follow-up (Z=-1.069 p=0.285). Prolonged exposure therapy for patients dually diagnosed with PNES and PTSD reduced the number of PNES and improved mood and post traumatic symptomatology. Follow-up revealed that gains made in seizure control on the last day of treatment were maintained over time. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Seizure duration with remifentanil/methohexital vs. methohexital alone in middle-aged patients undergoing electroconvulsive therapy.

    PubMed

    Smith, D L; Angst, M S; Brock-Utne, J G; DeBattista, C

    2003-10-01

    The object of this study was to test whether substituting part of the methohexital dose with the short-acting opioid remifentanil would prolong seizure duration in middle-aged patients while providing a similar depth of anesthesia as with methohexital alone. This has been reported for the combined use of methohexital and remifentanil in elderly patients, but has not been investigated in middle-aged patients likely to require a higher total dose of methohexital for inducing anesthesia. Seven patients (42+/-10 years; mean +/-SD) receiving electroconvulsive therapy (ECT) were anesthetized with methohexital (1.25 mg kg-1) or with methohexital (0.625 mg kg-1) plus remifentanil (1 micro g kg-1) in this randomized, double blind, crossover study. Additional methohexital was given as needed until loss of eyelash reflex was observed. Suxamethonium (1 mg kg-1) was used for muscular paralysis. Motor and EEG seizure durations were significantly longer after induction with methohexital plus remifentanil (45+/-14 and 58+/-15 s) than with methohexital alone (31+/-11 and 42+/-18 s). A methohexital dose of 1.2+/-0.3 and 1.9+/-0.3 mg was necessary to achieve loss of eyelash reflex if methohexital was used with and without remifentanil. Peak heart rate after ECT was significantly higher if remifentanil was coadministered with methohexital (148+/-12 vs. 126+/-24 b.p.m). Substituting part of the methohexital dose with remifentanil is a useful anesthetic technique to prolong seizure duration in middle-aged patients requiring a 1.5-fold higher induction dose of methohexital than elderly patients, the only population studied to date for the combined use of methohexital and remifentanil in ECT.

  17. Monitoring neonatal seizures.

    PubMed

    Boylan, Geraldine B; Stevenson, Nathan J; Vanhatalo, Sampsa

    2013-08-01

    Neonatal seizures are a neurological emergency and prompt treatment is required. Seizure burden in neonates can be very high, status epilepticus a frequent occurrence, and the majority of seizures do not have any clinical correlate. Detection of neonatal seizures is only possible with continuous electroencephalogram (EEG) monitoring. EEG interpretation requires special expertise that is not available in most neonatal intensive care units (NICUs). As a result, a simplified method of EEG recording incorporating an easy-to-interpret compressed trend of the EEG output (amplitude integrated EEG) from one of the EEG output from one or two channels has emerged as a popular way to monitor neurological function in the NICU. This is not without limitations; short duration and low amplitude seizures can be missed, artefacts are problematic and may mimic seizure-like activity and only a restricted area of the brain is monitored. Continuous multichannel EEG is the gold standard for detecting seizures and monitoring response to therapy but expert interpretation of the EEG output is generally not available. Some centres have set up remote access for neurophysiologists to the cot-side EEG, but reliable interpretation is wholly dependent on the 24 h availability of experts, an expensive solution. A more practical solution for the NICU without such expertise is an automated seizure detection system. This review outlines the current state of the art regarding cot-side monitoring of neonatal seizures in the NICU.

  18. MST1 is a novel regulator of apoptosis in pancreatic beta-cells

    PubMed Central

    Ardestani, Amin; Khobragade, Vrushali; Yuan, Ting; Frogne, Thomas; Tao, Wufan; Oberholzer, Jose; Pattou, Francois; Conte, Julie Kerr; Maedler, Kathrin

    2014-01-01

    Apoptotic cell death is a hallmark of the loss of insulin producing beta-cells in all forms of diabetes mellitus. Current treatment fails to halt the decline in functional beta-cell mass. Strategies to prevent beta-cell apoptosis and dysfunction are urgently needed. Here, we identified Mammalian Sterile 20-like kinase 1 (MST1) as a critical regulator of apoptotic beta-cell death and function. MST1 was strongly activated in beta-cells under diabetogenic conditions and correlated with beta-cell apoptosis. MST1 specifically induced the mitochondrial-dependent pathway of apoptosis in beta-cells through up-regulation of the BH3-only protein Bim. MST1 directly phosphorylated PDX1 at Thr11, resulting in its ubiquitination, degradation and impaired insulin secretion. Mst1 deficiency completely restored normoglycemia, beta-cell function and survival in vitro and in vivo. We show MST1 as novel pro-apoptotic kinase and key mediator of apoptotic signaling and beta-cell dysfunction, which may serve as target for the development of novel therapies for diabetes. PMID:24633305

  19. A randomized, double-blind, placebo-controlled, parallel-group study of rufinamide as adjunctive therapy for refractory partial-onset seizures.

    PubMed

    Biton, Victor; Krauss, Gregory; Vasquez-Santana, Blanca; Bibbiani, Francesco; Mann, Allison; Perdomo, Carlos; Narurkar, Milind

    2011-02-01

    Efficacy and safety of adjunctive rufinamide (3,200 mg/day) was assessed in adolescents and adults with inadequately controlled partial-onset seizures receiving maintenance therapy with up to three antiepileptic drugs (AEDs). This randomized, double-blind, placebo-controlled, parallel-group, multicenter study comprised a 56-day baseline phase (BP), 12-day titration phase, and 84-day maintenance phase (MP). The primary efficacy variable was percentage change in total partial seizure frequency per 28 days (MP vs. BP). Secondary efficacy outcome measures included ≥50% responder rate and reduction in mean total partial seizure frequency during the MP. Safety and tolerability evaluation included adverse events (AEs), physical and neurologic examinations, and laboratory values. Pharmacokinetic and pharmacodynamic assessments were conducted. Three hundred fifty-seven patients were randomized: 176 to rufinamide and 181 to placebo. Patients had a median of 13.3 seizures per 28 days during BP; 86% were receiving ≥2 AEDs. For the intent-to-treat population, the median percentage reduction in total partial seizure frequency per 28 days was 23.25 for rufinamide versus 9.80 for placebo (p = 0.007). Rufinamide-treated patients were more than twice as likely to have had a ≥50% reduction in partial seizure frequency (32.5% vs. 14.3%; p < 0.001) and had a greater reduction in median total partial seizure rate per 28 days during the MP (13.2 vs. 5.2; p < 0.001). Treatment-emergent AEs occurring at ≥5% higher incidence in the rufinamide group compared with placebo were dizziness, fatigue, nausea, somnolence, and diplopia. Adjunctive treatment with rufinamide reduced total partial seizures in refractory patients. AEs reported were consistent with the known tolerability profile of rufinamide. Wiley Periodicals, Inc. © 2010 International League Against Epilepsy.

  20. MST radar data-base management

    NASA Technical Reports Server (NTRS)

    Wickwar, V. B.

    1983-01-01

    Data management for Mesospheric-Stratospheric-Tropospheric, (MST) radars is addressed. An incoherent-scatter radar data base is discussed in terms of purpose, centralization, scope, and nature of the data base management system.

  1. [Ecstatic seizures].

    PubMed

    Likhachev, S A; Astapenko, A V; Osos, E L; Zmachynskaya, O L; Gvishch, T G

    2015-01-01

    Ecstatic seizures is a rare manifestation of epilepsy. They were described for the first time by F.M. Dostoevsky. Currently, the description of ecstatic seizures is possible to find in the scientific literature. The description of the own observation of a patient with emotional-affective seizures is presented. A role of the anterior insular cortex in the ecstatic seizures origin is discussed. The similarities between the feelings reported during ecstatic seizures and the feelings experienced under the effect of stimulant addictive drugs are described. The possible reasons of the low frequency of emotional-affective seizures are considered.

  2. [The influence of cognitive-behavioral therapy on the P300 potential in children with psychogenic nonepileptic seizures and tension headache].

    PubMed

    Stolarska-Weryńska, Urszula; Steczkowska, Małgorzata; Kaciński, Marek

    2016-01-01

    Explaining associations between neurophysiological and neuropsychological parameteres in children and improving the measurement methods would lead to a better understanding of the pathogenesis and course of psychosomatic disease. Goal: clinical assessment of the efficacy of cognitive-behavioral therapy in the treatment of psychogenic no- nepileptic seizures and tension type headaches in children. Determining the influence of cognitive behavioral therapy on the cognitive P300 potential and whether P300 parameters in children correlate with neuropsychological parameters. 20 children with nonepileptic psychogenic seizures and 30 children with tension type headaches, aged 11.3 - 17.11 years. The final diagnosis was made in the Paediatric Neurology Clinic. The P300 examination was performed before/after therapy, with/without hyperventilation. A fixed structure therapy was implemented (10 sessions, 90 minutes each), during two weeks of hospitalization or in an outpatient clinic (9 children with tension type headache). The psychological assessment comprised of temperament questionnaires, auditory and visual memory trials, executive function and attention trials, and in some cases also intelligence testing. More significant correlations were found in children with psychogenic seizures: attention parameters correlated negatively with reaction time, and this correlation tended to fade in the second examination, after psychotherapy. In children with tension type headache a statistically insignificant tendency was found of a positive correlation between those parameters. Medium P300 parameteres in this group were better. In 17/20 of children with psychogenic seizures a clinical improvement was observed, in 3 children the symptoms persisted in a 6 month follow up, but of a lower frequency. In 11/27 of chil- dren with tension headache the symptoms persisted, also with a lower frequency. cognitive-behavioral therapy is effective in the reduction of symptoms in many cases of

  3. Combined diazepam and MK-801 therapy provides synergistic protection from tetramethylenedisulfotetramine-induced tonic-clonic seizures and lethality in mice.

    PubMed

    Shakarjian, Michael P; Ali, Mahil S; Velíšková, Jana; Stanton, Patric K; Heck, Diane E; Velíšek, Libor

    2015-05-01

    The synthetic rodenticide, tetramethylenedisulfotetramine (TMDT), is a persistent and highly lethal GABA-gated Cl(-) channel blocker. TMDT is clandestinely produced, remains popular in mainland China, and causes numerous unintentional and deliberate poisonings worldwide. TMDT is odorless, tasteless, and easy to manufacture, features that make it a potential weapon of terrorism. There is no effective treatment. We previously characterized the effects of TMDT in C57BL/6 mice and surveyed efficacies of GABAergic and glutamatergic anticonvulsant treatments. At 0.4 mg/kg i.p., TMDT produced neurotoxic symptomatology consisting of twitches, clonic and tonic-clonic seizures, often progressing to status epilepticus and death. If administered immediately after the occurrence of the first clonic seizure, the benzodiazepine diazepam (DZP) effectively prevented all subsequent seizure symptoms, whereas the NMDA receptor antagonist dizocilpine (MK-801) primarily prevented tonic-clonic seizures. The latter agent, however, appeared to be more effective at preventing delayed death. The present study further explored these phenomena, and characterized the therapeutic actions of DZP and MK-801 as combinations. Joint treatment with both DZP and MK-801 displayed synergistic protection against tonic-clonic seizures and 24 h lethality as determined by isobolographic analysis. Clonic seizures, however, remained poorly controlled. A modification of the treatment regimen, where DZP was followed 10 min later by MK-801, yielded a reduction in both types of seizures and improved overall outcome. Simultaneous monitoring of subjects via EEG and videography confirmed effectiveness of this sequential regimen. We conclude that TMDT blockage at GABAA receptors involves early activation of NMDA receptors, which contribute to persistent ictogenic activity. Our data predict that a sequential combination treatment with DZP followed by MK-801 will be superior to either individual therapy with, or

  4. Impact of an oral theophylline loading dose pre-electroconvulsive therapy: a retrospective study in patients with missed or inadequate seizures.

    PubMed

    Kemp, Michael F; Allard, Jacques; Pâquet, Myriam; Marcotte, Patrick

    2015-03-01

    The aim of this study was to determine the safety and impact of an oral theophylline loading dose calculated to achieve a 10- to 15-mg/L plasma concentration when administered 1.5 hours before electroconvulsive therapy (ECT). We conducted a retrospective study using inpatient hospital records between January 2007 and June 2012 at the Dr. Georges L. Dumont University Hospital Centre. Patients receiving a series of ECTs with a calculated theophylline loading dose were selected. Variables collected include ECT parameters for each ECT, medications received, and treatment-related side effects. We identified 35 patients and analyzed 14 who had no treatment modifications except for the addition of theophylline. The mean predicted theophylline plasma concentration was 12.99 (SD, 1.09) mg/L with dosages ranging from 260 to 600 mg. Eight patients (89%) with abortive seizures and 4 (80%) with missed seizures achieved a seizure duration of greater than 15 seconds with theophylline. Seizure duration increased by 165.6% (+21.3 seconds; P = 0.048) with theophylline, and all patients (N = 5) with a maximum sustained coherence of less than 92% achieved an increase after theophylline; however, the overall increase (+8.8%, P = 0.087) was not significant. No theophylline-related adverse events were documented in 128 ECTs with theophylline, and no seizure exceeded 120 seconds. A calculated theophylline loading dose before ECT is well tolerated and effective in prolonging seizure duration and aiding with seizure generation in patients who do not seize readily. Its positive impact in patients with lower maximum sustained coherence, in addition to the potential existence of a dose-response relationship, should be further investigated.

  5. Hyponatraemia and seizures after ecstasy use.

    PubMed

    Holmes, S B; Banerjee, A K; Alexander, W D

    1999-01-01

    A patient presented to our unit with seizures and profound hyponatraemia after ingestion of a single tablet of ecstasy. The seizures proved resistant to therapy and ventilation on the intensive care unit was required. Resolution of the seizures occurred on correction of the metabolic abnormalities. The pathogenesis of seizures and hyponatraemia after ecstasy use is discussed. Ecstasy use should be considered in any young patient presenting with unexplained seizures and attention should be directed towards electrolyte levels, particularly sodium.

  6. Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures

    PubMed Central

    Mumoli, Laura; Palleria, Caterina; Gasparini, Sara; Citraro, Rita; Labate, Angelo; Ferlazzo, Edoardo; Gambardella, Antonio; De Sarro, Giovambattista; Russo, Emilio

    2015-01-01

    Brivaracetam (BRV), a high-affinity synaptic vesicle protein 2A ligand, reported to be 10–30-fold more potent than levetiracetam (LEV), is highly effective in a wide range of experimental models of focal and generalized seizures. BRV and LEV similarly bind to synaptic vesicle protein 2A, while differentiating for other pharmacological effects; in fact, BRV does not inhibit high voltage Ca2+ channels and AMPA receptors as LEV. Furthermore, BRV apparently exhibits inhibitory activity on neuronal voltage-gated sodium channels playing a role as a partial antagonist. BRV is currently waiting for approval both in the United States and the European Union as adjunctive therapy for patients with partial seizures. In patients with photosensitive epilepsy, BRV showed a dose-dependent effect in suppressing or attenuating the photoparoxysmal response. In well-controlled trials conducted to date, adjunctive BRV demonstrated efficacy and good tolerability in patients with focal epilepsy. BRV has a linear pharmacokinetic profile. BRV is extensively metabolized and excreted by urine (only 8%–11% unchanged). The metabolites of BRV are inactive, and hydrolysis of the acetamide group is the mainly involved metabolic pathway; hepatic impairment probably requires dose adjustment. BRV does not seem to influence other antiepileptic drug plasma levels. Six clinical trials have so far been completed indicating that BRV is effective in controlling seizures when used at doses between 50 and 200 mg/d. The drug is generally well-tolerated with only mild-to-moderate side effects; this is confirmed by the low discontinuation rate observed in these clinical studies. The most common side effects are related to central nervous system and include fatigue, dizziness, and somnolence; these apparently disappear during treatment. In this review, we analyzed BRV, focusing on the current evidences from experimental animal models to clinical studies with particular interest on potential use in clinical

  7. Predictors of Seizure Threshold in Right Unilateral Ultrabrief Electroconvulsive Therapy: Role of Concomitant Medications and Anaesthesia Used.

    PubMed

    Gálvez, Verònica; Hadzi-Pavlovic, Dusan; Smith, Deidre; Loo, Colleen K

    2015-01-01

    An individualized approach to maximize electroconvulsive therapy (ECT) efficacy and minimize cognitive side effects is to treat patients relative to their seizure threshold (ST). However, although Right Unilateral-Ultrabrief (0.3 ms) (RUL-UB) ECT is increasingly used in clinical settings as an effective form of ECT with minimal cognitive effects, there is sparse data regarding predictors of ST. To analyze the relationship between ST and clinical and demographic factors in a sample of patients treated with RUL-UB ECT. Clinical, demographic and ECT data from 179 patients in ECT research studies were examined. Seizure threshold was titrated at the first ECT session. ECT was performed with a Thymatron(®) or Mecta(®) device, with thiopentone (2.5-5 mg/kg) or propofol (1-2 mg/kg) anaesthesia. Medications taken at the time of ST titration were documented. The association between ST and candidate predictor variables was examined with regression analysis. Multiple regression analyses showed that 34% of the variance in ST (P < 0.001) could be predicted. Older age (R(2) = 0.194, P < 0.001), propofol (vs thiopentone) (R(2) = 0.029, P ≤ 0.01) and higher anaesthetic dose (mg in propofol equivalents) (R(2) = 0.029, P < 0.05) were found to be predictors of higher initial ST. Treatment with lithium (R(2) = 0.043, P < 0.01) and study site (R(2) = 0.019, P < 0.05) significantly predicted lower initial ST. Empirical titration is recommended for accurate determination of ST in patients receiving RUL-UB ECT. Novel findings of this study are that propofol anaesthesia resulted in higher ST than thiopentone and concomitant treatment with lithium treatment lowered ST. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. The Telomerase Inhibitor MST-312 Interferes with Multiple Steps in the Herpes Simplex Virus Life Cycle.

    PubMed

    Haberichter, Jarod; Roberts, Scott; Abbasi, Imran; Dedthanou, Phonphanh; Pradhan, Prajakta; Nguyen, Marie L

    2015-10-01

    The life cycle of herpes simplex virus (HSV) has the potential to be further manipulated to yield novel, more effective therapeutic treatments. Recent research has demonstrated that HSV-1 can increase telomerase activity and that expression of the catalytic component of telomerase, telomerase reverse transcriptase (TERT), alters sensitivity to HSV-dependent apoptosis. Telomerase is a cellular enzyme that synthesizes nucleotide repeats at the ends of chromosomes (telomeres), which prevents shortening of the 3' ends of DNA with each cell division. Once telomeres reach a critical length, cells undergo senescence and apoptosis. Here, we used a cell-permeable, reversible inhibitor of the telomerase enzyme, MST-312, to investigate telomerase activity during HSV infection. Human mammary epithelial cells immortalized through TERT expression and human carcinoma HEp-2 cells were infected with the KOS1.1 strain of HSV-1 in the presence of MST-312. MST-312 treatment reduced the number of cells displaying a cytopathic effect and the accumulation of immediate early and late viral proteins. Moreover, the presence of 20 μM to 100 μM MST-312 during infection led to a 2.5- to 5.5-log10 decrease in viral titers. MST-312 also inhibited the replication of HSV-2 and a recent clinical isolate of HSV-1. Additionally, we determined that MST-312 has the largest impact on viral events that take place prior to 5 h postinfection (hpi). Furthermore, MST-312 treatment inhibited virus replication, as measured by adsorption assays and quantification of genome replication. Together, these findings demonstrate that MST-312 interferes with the HSV life cycle. Further investigation into the mechanism for MST-312 is warranted and may provide novel targets for HSV therapies. Herpes simplex virus (HSV) infections can lead to cold sores, blindness, and brain damage. Identification of host factors that are important for the virus life cycle may provide novel targets for HSV antivirals. One such factor

  9. Frontal lobe seizures.

    PubMed

    Bagla, Ritu; Skidmore, Christopher T

    2011-05-01

    Frontal lobe epilepsy is the second most common localization-related or focal epilepsy. Frontal lobe seizures are challenging to diagnose as the clinical manifestations are diverse due to the complexity and variability of the patterns of epileptic discharges, and the scalp electroencephalograph (EEG) can often be normal or misleading. This review focuses on the clinical and EEG features of seizures arising from the frontal lobe. The clinical manifestations in patients with frontal lobe epilepsy are varied. Frontal lobe seizures can be divided into perirolandic, supplementary sensorimotor area, dorsolateral, orbitofrontal, anterior frontopolar, opercular, and cingulate types. Seizures originating from the perirolandic and supplementary sensorimotor areas are clinically distinct, characterized by motor activity or asymmetric tonic posturing with preserved awareness. Seizures arising from dorsolateral, orbitofrontal, frontopolar, and cingulate areas are not as well characterized and have more variable clinical manifestations. Scalp EEG recording is sometimes helpful in localization but is usually normal or misleading in frontal lobe epilepsy. The treatment is similar to other localization-related or focal epilepsies. Medications are the first line of therapy, and surgery is considered for patients who fail to respond to medications. The surgical outcome in frontal lobe resections is less favorable than in anterior temporal lobectomies due to the challenge in locating the epileptogenic zone and the presence of functional areas (eloquent cortex) that can limit the resection. Frontal lobe seizures are characterized by diverse behavioral manifestations. Only a few well-described frontal lobe syndromes exist. The variety of clinical manifestations reflects both the varying sites of seizure origin and propagation routes that seizures may take. Although this review provides a framework for the understanding of these seizures, one should remain cautious in diagnosing seizure

  10. Rheology Of MonoSodium Titanate (MST) And Modified Mst (mMST) Mixtures Relevant To The Salt Waste Processing Facility

    SciTech Connect

    Koopman, D. C.; Martino, C. J.; Shehee, T. C.; Poirier, M. R.

    2013-07-31

    The Savannah River National Laboratory performed measurements of the rheology of suspensions and settled layers of treated material applicable to the Savannah River Site Salt Waste Processing Facility. Suspended solids mixtures included monosodium titanate (MST) or modified MST (mMST) at various solid concentrations and soluble ion concentrations with and without the inclusion of kaolin clay or simulated sludge. Layers of settled solids were MST/sludge or mMST/sludge mixtures, either with or without sorbed strontium, over a range of initial solids concentrations, soluble ion concentrations, and settling times.

  11. Pharmacokinetic optimization of benzodiazepine therapy for acute seizures. Focus on delivery routes.

    PubMed

    Rey, E; Tréluyer, J M; Pons, G

    1999-06-01

    All benzodiazepines enter cerebral tissue rapidly. However, the duration of action is short for diazepam (< 2 hours) and midazolam (3 to 4 hours) and longer for clonazepam (24 hours) and lorazepam (up to 72 hours), and is not correlated with the plasma concentration-time profiles of these drugs. Although a relationship between the plasma concentration of diazepam, lorazepam and midazolam and their pharmacodynamic effect has been demonstrated in healthy individuals, some caution is warranted as the clinical relevance of these data has not been clearly established. The physicochemical properties of benzodiazepines (lipid solubility and protein binding) regulate their rate and extent of entry into the brain and cerebrospinal fluid. However, the duration of the pharmacological activity of benzodiazepines may be in part related to the affinity of these compounds for the benzodiazepine receptors in the brain: midazolam, clonazepam and lorazepam have higher affinities than diazepam. In the emergency setting, the intravenous route is the most suitable, delivering adequate quantities of benzodiazepines as fast as possible. However, when intravenous administration is not available, rectal administration of a solution is a convenient method for diazepam, midazolam being the only one of these drugs that should be given intramuscularly. The assessment of the efficacy of benzodiazepines in the management of acute seizures and status epilepticus is mainly based on nonrandomized uncontrolled trials. According to the route of administration, the efficacy was 28.6 to 100% (intrarectal) and 54 to 100% (intravenous) for diazepam, 82 to 100% (intravenous) for lorazepam, and 79% (intranasal), 93 to 100% (intramuscular) and 100% (intravenous) for midazolam. Although diazepam was initially chosen for the management of refractory status epilepticus, the longer duration of action of lorazepam and clonazepam may favour the use of these 2 drugs. However, double-blind evaluations are necessary

  12. 21. DETAIL OF AIR HANDLER 1 (MST AIRCONDITIONING SYSTEM) INTERIOR, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. DETAIL OF AIR HANDLER 1 (MST AIR-CONDITIONING SYSTEM) INTERIOR, SOUTHEAST CORNER, STATION 30, SLC-3W MST - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  13. Bridging the Gap between Science and Practice: The Effective Nationwide Transport of MST Programs in Norway

    ERIC Educational Resources Information Center

    Ogden, Terje; Christensen, Bernadette; Sheidow, Ashli J.; Holth, Per

    2008-01-01

    The successful nationwide transport and evaluation of Multisystemic Therapy (MST) programs in Norway is described. This description is provided within the context of the nation's movement towards the adoption of evidence-based practices (EBPs) during the past decade, the conduct of a multisite randomized clinical trial to examine the effectiveness…

  14. Common and Specific Factors Approaches to Home-Based Treatment: I-FAST and MST

    ERIC Educational Resources Information Center

    Lee, Mo Yee; Greene, Gilbert J.; Fraser, J. Scott; Edwards, Shivani G.; Grove, David; Solovey, Andrew D.; Scott, Pamela

    2013-01-01

    Objectives: This study examined the treatment outcomes of integrated families and systems treatment (I-FAST), a moderated common factors approach, in reference to multisystemic therapy (MST), an established specific factor approach, for treating at risk children and adolescents and their families in an intensive community-based setting. Method:…

  15. Febrile seizures.

    PubMed

    Patterson, Janet L; Carapetian, Stephanie A; Hageman, Joseph R; Kelley, Kent R

    2013-12-01

    Febrile seizures are the most common form of childhood seizures, affecting 2% to 5% of children. They are considered benign and self-limiting; however, a febrile seizure is a terrifying event for most parents, and is one of the most common causes of trips to the emergency room. A febrile seizure is "an event in infancy or childhood, usually occurring between 3 months and 5 years of age, associated with fever but without evidence of intracranial infection or defined cause." This definition excludes seizures with fever in children who have had a prior afebrile seizure. In 2011, The American Academy of Pediatrics (AAP) published a clinical practice guideline defining a febrile seizure as "a seizure accompanied by fever (temperature ≥ 100.4°F or 38°C by any method), without central nervous system infection, that occurs in infants and children 6 through 60 months of age." Febrile seizures are further classified as simple or complex. This article reviews the evaluation, management, and prognosis of simple and complex seizures, including febrile status epilepticus. Copyright 2013, SLACK Incorporated.

  16. MST e-News June 2016

    SciTech Connect

    Kippen, Karen Elizabeth

    2016-06-17

    This is Los Alamos National Laboratory's (LANL) June 2016 newsletter of the Materials Science and Technology Division. The following are major topics in this newsletter: MST-8 scientists guide national efforts to overcome nuclear energy technical challenges, first-ever scanning probe microscopy capabilities for plutonium, laboratory metallurgists make thorium targets for production of cancer-fighting isotopes, and a spotlight on Veronica Livescu.

  17. 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

  18. Hyponatraemia and seizures after ecstasy use

    PubMed Central

    Holmes, S.; Banerjee, A.; Alexander, W.

    1999-01-01

    A patient presented to our unit with seizures and profound hyponatraemia after ingestion of a single tablet of ecstasy. The seizures proved resistant to therapy and ventilation on the intensive care unit was required. Resolution of the seizures occurred on correction of the metabolic abnormalities. The pathogenesis of seizures and hyponatraemia after ecstasy use is discussed. Ecstasy use should be considered in any young patient presenting with unexplained seizures and attention should be directed towards electrolyte levels, particularly sodium.


Keywords: ecstasy; seizures; hyponatraemia PMID:10396584

  19. Febrile Seizures

    MedlinePlus

    ... to pinpoint factors that can help predict which children are likely to have reoccurring or prolonged febrile seizures. Investigators continue to monitor the long-term impact that febrile seizures might have on intelligence, behavior, school achievement, and the development of epilepsy. ...

  20. Seizures in the context of acute illness.

    PubMed

    Riviello, James J

    2009-12-01

    Seizures during an acute illness demand immediate evaluation, as they indicate an acute central nervous system insult. There are three goals: identify and treat the precipitating cause; determine the need for antiepileptic drug therapy; and recognize nonconvulsive seizures. Management depends upon whether there is a primary or secondary central nervous system insult. Seizures may persist despite antiepileptic drugs if the precipitating cause is untreated. Seizures and epilepsy and children with neurodevelopmental disabilities comprise a significant percentage of acute care in children. A continuum exists from a single seizure and escalating seizures to status epilepticus. Seizure treatment is more successful when given earlier, and prognosis depends on the cause. Guidelines for the diagnostic evaluation and treatment of status epilepticus have been produced. Continuous electroencephalographic monitoring reveals frequent nonconvulsive seizures and nonconvulsive status epilepticus in the sick child. The recognition and rapid treatment of clinical and electrographic seizures is important during acute illness.

  1. Comprehensive treatment for co-occurring child maltreatment and parental substance abuse: outcomes from a 24-month pilot study of the MST-Building Stronger Families program.

    PubMed

    Schaeffer, Cindy M; Swenson, Cynthia Cupit; Tuerk, Elena Hontoria; Henggeler, Scott W

    2013-08-01

    This manuscript presents outcomes from a pilot study of Multisystemic Therapy-Building Stronger Families (MST-BSF), an integrated treatment model for the co-occurring problem of parental substance abuse and child maltreatment among families involved in the child welfare system. Participants were 25 mother-youth dyads who participated in MST-BSF and an additional 18 families with similar demographic and case characteristics who received Comprehensive Community Treatment (CCT). At post-treatment, mothers who received MST-BSF showed significant reductions in alcohol use, drug use, and depressive symptoms; they also significantly reduced their use of psychological aggression with the youth. Youth reported significantly fewer anxiety symptoms following MST-BSF treatment. Relative to families who received CCT, mothers who received MST-BSF were three times less likely to have another substantiated incident of maltreatment over a follow-up period of 24 months post-referral. The overall number of substantiated reabuse incidents in this time frame also was significantly lower among MST-BSF families, and youth who received MST-BSF spent significantly fewer days in out-of-home placements than did their CCT counterparts. These promising preliminary outcomes support the viability of a more rigorous (i.e., randomized) evaluation of the MST-BSF model.

  2. Pharmacological targeting of kinases MST1 and MST2 augments tissue repair and regeneration.

    PubMed

    Fan, Fuqin; He, Zhixiang; Kong, Lu-Lu; Chen, Qinghua; Yuan, Quan; Zhang, Shihao; Ye, Jinjin; Liu, Hao; Sun, Xiufeng; Geng, Jing; Yuan, Lunzhi; Hong, Lixin; Xiao, Chen; Zhang, Weiji; Sun, Xihuan; Li, Yunzhan; Wang, Ping; Huang, Lihong; Wu, Xinrui; Ji, Zhiliang; Wu, Qiao; Xia, Ning-Shao; Gray, Nathanael S; Chen, Lanfen; Yun, Cai-Hong; Deng, Xianming; Zhou, Dawang

    2016-08-17

    Tissue repair and regenerative medicine address the important medical needs to replace damaged tissue with functional tissue. Most regenerative medicine strategies have focused on delivering biomaterials and cells, yet there is the untapped potential for drug-induced regeneration with good specificity and safety profiles. The Hippo pathway is a key regulator of organ size and regeneration by inhibiting cell proliferation and promoting apoptosis. Kinases MST1 and MST2 (MST1/2), the mammalian Hippo orthologs, are central components of this pathway and are, therefore, strong target candidates for pharmacologically induced tissue regeneration. We report the discovery of a reversible and selective MST1/2 inhibitor, 4-((5,10-dimethyl-6-oxo-6,10-dihydro-5H-pyrimido[5,4-b]thieno[3,2-e][1,4]diazepin-2-yl)amino)benzenesulfonamide (XMU-MP-1), using an enzyme-linked immunosorbent assay-based high-throughput biochemical assay. The cocrystal structure and the structure-activity relationship confirmed that XMU-MP-1 is on-target to MST1/2. XMU-MP-1 blocked MST1/2 kinase activities, thereby activating the downstream effector Yes-associated protein and promoting cell growth. XMU-MP-1 displayed excellent in vivo pharmacokinetics and was able to augment mouse intestinal repair, as well as liver repair and regeneration, in both acute and chronic liver injury mouse models at a dose of 1 to 3 mg/kg via intraperitoneal injection. XMU-MP-1 treatment exhibited substantially greater repopulation rate of human hepatocytes in the Fah-deficient mouse model than in the vehicle-treated control, indicating that XMU-MP-1 treatment might facilitate human liver regeneration. Thus, the pharmacological modulation of MST1/2 kinase activities provides a novel approach to potentiate tissue repair and regeneration, with XMU-MP-1 as the first lead for the development of targeted regenerative therapeutics.

  3. MST radar observation in international programs

    NASA Astrophysics Data System (ADS)

    Kato, Susumu

    1993-08-01

    MST radars played an important role in the observation of middle atmosphere dynamics in MAP. The radars have made it possible, for the first time, to observe the precise behaviour of atmospheric gravity waves which had so far been suspected, without definite observations, to contribute to produce weak winds around the mesopause. The facilities then built in various places as in the U.S.A., Germany and Japan detected some crucial behaviors to prove the existence of gravity waves breaking in these heights, showing a release of the momentum as required for producing the weak wind region. Since MAP through MAC to STEP which is now going, MST radars have been increasingly active, with increase of the facilities over the globe, in the observation of atmospheric dynamics from near the ground up to the mesosphere. Besides winds, gravity waves and turbulence, the facilities are now found to be able to observe precise structures of various meteorological disturbances as weather-fronts, typhoon, etc. Even the gap without echoes so far between the middle stratosphere and the lower mesosphere would disappear with an appearance of very powerful facilities in future. Like MST radars, ST radars are well developed. They are also pulsed-doppler radars working on VHF radio waves as MST radars, but less sensitive as to be able to observe only the lower stratosphere and the troposphere. ST radars are economical and widely used for unattended observation and in setting-up networks in international programs. ST radars work as meteor radars simply by installing a small device, Medac, to the original systems. Medium frequency (MF) radars suit mesosphere and lower thermosphere observation; they operate with fairly low power, suitable for continuous observation.

  4. Rassf Proteins as Modulators of Mst1 Kinase Activity

    PubMed Central

    Bitra, Aruna; Sistla, Srinivas; Mariam, Jessy; Malvi, Harshada; Anand, Ruchi

    2017-01-01

    Rassf1A/5 tumor suppressors serve as adaptor proteins possessing a modular architecture with the C-terminal consisting of a coiled-coil SARAH (Salvador-Rassf-Hippo) domain and the central portion being composed of Ras associated (RA) domain. Here, we investigate the effect of Rassf effectors on Mst1 function by mapping the interaction of various domains of Rassf1A/5 and Mst1 kinase using surface plasmon resonance (SPR). The results revealed that apart from the C-terminal SARAH domain of Mst1 which interacts to form heterodimers with Rassf1A/5, the N-terminal kinase domain of Mst1 plays a crucial role in the stabilization of this complex. In addition, SPR experiments show that the RA domains play an important role in fine-tuning the Mst1-Rassf interaction, with Rassf5 being a preferred partner over a similar Rassf1A construct. It was also demonstrated that the activity profile of Mst1 in presence of Rassf adaptors completely switches. A Rassf-Mst1 complexed version of the kinase becomes apoptotic by positively regulating Mst1-H2B mediated serine 14 histone H2B phosphorylation, a hallmark of chromatin condensation. In contrast, the heterodimerization of Mst1 with Rassf1A/5 suppresses the phosphorylation of FoxO, thereby inhibiting the downstream Mst1-FoxO signalling pathway. PMID:28327630

  5. Rassf Proteins as Modulators of Mst1 Kinase Activity.

    PubMed

    Bitra, Aruna; Sistla, Srinivas; Mariam, Jessy; Malvi, Harshada; Anand, Ruchi

    2017-03-22

    Rassf1A/5 tumor suppressors serve as adaptor proteins possessing a modular architecture with the C-terminal consisting of a coiled-coil SARAH (Salvador-Rassf-Hippo) domain and the central portion being composed of Ras associated (RA) domain. Here, we investigate the effect of Rassf effectors on Mst1 function by mapping the interaction of various domains of Rassf1A/5 and Mst1 kinase using surface plasmon resonance (SPR). The results revealed that apart from the C-terminal SARAH domain of Mst1 which interacts to form heterodimers with Rassf1A/5, the N-terminal kinase domain of Mst1 plays a crucial role in the stabilization of this complex. In addition, SPR experiments show that the RA domains play an important role in fine-tuning the Mst1-Rassf interaction, with Rassf5 being a preferred partner over a similar Rassf1A construct. It was also demonstrated that the activity profile of Mst1 in presence of Rassf adaptors completely switches. A Rassf-Mst1 complexed version of the kinase becomes apoptotic by positively regulating Mst1-H2B mediated serine 14 histone H2B phosphorylation, a hallmark of chromatin condensation. In contrast, the heterodimerization of Mst1 with Rassf1A/5 suppresses the phosphorylation of FoxO, thereby inhibiting the downstream Mst1-FoxO signalling pathway.

  6. Fast Particle Resonant Modes on MST*

    NASA Astrophysics Data System (ADS)

    Koliner, J. J.; Forest, C. B.; Sarff, J. S.; Anderson, J. K.; Lin, L.; Ding, W. X.; Brower, D. L.; Spong, D. A.

    2011-10-01

    The interaction between fast particles and Alfvén eigenmodes (AE's) is an important process critical to magnetically confined fusion plasmas. An effort is in progress to understand AE's through theory and experiment on MST, a reversed-field pinch. Coupling of energetic particle dynamics to one or more continuum modes can introduce undamped AE's. This coupling can drive modes unstable, a condition pertinent to NBI on MST and fusion alpha particles in future RFP devices. Computational studies for MST have predicted toroidal AE's with frequencies in the 200-300 kHz range and global structure. Alfvén-wave-frequency modes have been observed with up to 1 MW of NBI. Toroidal and poloidal arrays of magnetic loops are utilized to find edge amplitudes, frequencies and mode numbers. Frequencies are in the 60-150 kHz range with n=4 and n=5, m=1. The strongest coherent activity scales inversely with density, as expected for AE's, but does not scale with magnetic field strength. Additional experiments to investigate resonance conditions and beam energy scaling have been performed. An FIR interferometer-polarimeter has been used to find internal structure of the detected modes through correlation analysis. *Supported by USDoE and NSF.

  7. Antenna induced range smearing in MST radars

    NASA Technical Reports Server (NTRS)

    Watkins, B. J.; Johnston, P. E.

    1984-01-01

    There is considerable interest in developing stratosphere troposphere (ST) and mesosphere stratosphere troposphere (MST) radars for higher resolution to study small-scale turbulent structures and waves. At present most ST and MST radars have resolutions of 150 meters or larger, and are not able to distinguish the thin (40 - 100 m) turbulent layers that are known to occur in the troposphere and stratosphere, and possibly in the mesosphere. However the antenna beam width and sidelobe level become important considerations for radars with superior height resolution. The objective of this paper is to point out that for radars with range resolutions of about 150 meters or less, there may be significant range smearing of the signals from mesospheric altitudes due to the finite beam width of the radar antenna. At both stratospheric and mesospheric heights the antenna sidelobe level for lear equally spaced phased arrays may also produce range aliased signals. To illustrate this effect the range smearing functions for two vertically directed antennas have been calculated, (1) an array of 32 coaxial-collinear strings each with 48 elements that simulates the vertical beam of the Poker Flat, Glaska, MST radar; and (2) a similar, but smaller, array of 16 coaxial-collinear strings each with 24 elements.

  8. The MST technique - A brief review

    NASA Astrophysics Data System (ADS)

    Balsley, B. B.

    1981-06-01

    A review of the MST (mesosphere-stratosphere-troposphere) radar technique for remote atmospheric observations in the height range 1-100 km is presented, with examples given which were obtained mainly from observatories located within the tropics, the Jicamarca Radar Observatory in Peru, the Arecibo Radar Observatory in Puerto Rico, and the Altair Radar facility on the Marshall Islands. Parameters for some coherent pulsed radar systems involved in clear air studies are presented. Restrictions in the use of MST techniques include (1) the need to transmit at high power levels and to have large physical aperture antennas and (2) the requirement that the operating frequency, i.e., only the lowest frequencies in the VHF range, be capable of 'seeing' turbulence above 50 km. Data presentation is discussed, and a sample of Doppler spectra and a comparison of zonal velocities by the Jicamarca radar and rockets at Ascension Island is used as an illustration. Some of the current MST capabilities are demonstrated, but the necessity of having additional equatorial-region observatories is stressed. An example of a reasonably economical system is discussed.

  9. Ezogabine: an evaluation of its efficacy and safety as adjunctive therapy for partial-onset seizures in adults.

    PubMed

    Yamada, Mikiko; Welty, Timothy E

    2012-10-01

    To evaluate the safety, efficacy, pharmacokinetics, pharmacodynamic properties, and clinical application of ezogabine (retigabine, INN), an antiepileptic drug approved in 2011. Published data from in vitro, animal, and clinical studies were obtained from PubMed and CINAHL searches, from January 1980 to March 31, 2012. Other relevant data regarding the safety and efficacy of ezogabine were obtained from the Food and Drug Administration and the European Medication Agency Web sites. Selected articles were prospective in vitro, animal, and controlled clinical studies of ezogabine. Non-English-language articles were excluded. In vitro and animal studies show that ezogabine activates voltagegated potassium channels, leading to reduction of seizure frequency by inhibiting hyperexcitability activity in the central nervous system. Additionally, ezogabine enhances γ-aminobutyric acid (GABA) activity and de novo GABA synthesis. Eight clinical studies of ezogabine have been published, 5 being Phase 1 clinical trials in healthy subjects and 3 being Phase 3 clinical trials in patients with pharmaco-resistant partial-onset seizures. Phase 3 clinical trials demonstrated the safety and efficacy of ezogabine in patients with partial-onset seizures. Clinical trials have shown that ezogabine is efficacious as an adjunctive agent in patients with pharmacoresistant partial seizures. Careful monitoring of drug interactions and adverse reactions is necessary. While ezogabine is efficacious for partial seizures, its precise role in the management of patients with epilepsy is yet to be determined.

  10. Febrile seizures.

    PubMed

    Mewasingh, Leena D

    2010-11-24

    Simple febrile seizures are generalised in onset, last <15 minutes, and do not occur more than once in 24 hours. Complex febrile seizures are longer lasting, have focal symptoms, and can recur within 24 hours. This review only deals with simple febrile seizures. About 2% to 5% of children in the USA and Western Europe, and 6% to 9% of infants and children in Japan will have experienced at least one febrile seizure by the age of 5 years. Simple febrile seizures may slightly increase the risk of developing epilepsy, but have no known adverse effects on behaviour, scholastic performance, or neurocognition. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments given during episodes of fever in children with one or more previous simple febrile seizures? What are the effects of long-term (daily, for >1 month) anticonvulsant treatment in children with a history of simple febrile seizures? What are the effects of treatments on reducing the risk of subsequent epilepsy in children with a history of simple febrile seizures? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 18 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: anticonvulsants (intermittent or continuous) and antipyretic treatments (physical antipyretic measures, paracetamol, ibuprofen).

  11. Dopey's seizure.

    PubMed

    Dan, B; Christiaens, F

    1999-06-01

    Angelman syndrome is a neurogenetic condition namely characterized by developmental delay, virtual absence of expressive verbal language, peculiar organization of movement, seizures and happy demeanor. This syndrome has been recognized since 1965, but it seems that Walt Disney presented an original depiction of it in his first full-length animated film, including myoclonic jerks and an apparently generalized tonic-clonic seizure. Copyright 1999 BEA Trading Ltd.

  12. TESTING AND CHARACTERIZATION OF ENGINEERED FORMS OF MONOSODIUM TITANATE (MST)

    SciTech Connect

    Taylor-Pashow, K.; Nash, C.; Hobbs, D.

    2012-05-14

    Engineered forms of MST and mMST were prepared at ORNL using an internal gelation process. Samples of these two materials were characterized at SRNL to examine particle size and morphology, peroxide content, tapped densities, and Na, Ti, and C content. Batch contact tests were also performed to examine the performance of the materials. The {sup E}mMST material was found to contain less than 10% of the peroxide found in a freshly prepared batch of mMST. This was also evidenced in batch contact testing with both simulated and actual waste, where little difference in performance was seen between the two engineered materials, {sup E}MST and {sup E}mMST. Based on these results, attempts were made to increase the peroxide content of the materials by post-treatment with hydrogen peroxide. The peroxide treatment resulted in a slight ({approx}10%) increase in peroxide content; however, the peroxide:Ti molar ratio was still much lower ({approx}0.1 X) than what is seen in a freshly prepared batch of mMST. Testing with simulated waste showed the performance of the peroxide treated materials was improved. Batch contact tests were also performed with an earlier (2003) prepared lot of {sup E}MST to examine the effect of ionic strength on the performance of the material. In general the results showed a decrease in removal performance with increasing ionic strength, which is consistent with previous testing with MST. A Sr loading isotherm was also determined, and the {sup E}MST material was found to reach a Sr loading as high as 13.2 wt % after 100 days of contact at a phase ratio of 20000 mL/g. At the typical MST phase ratio of 2500 mL/g (0.4 g/L), a Sr loading of 2.64 wt % was reached after 506 hours of contact. Samples of {sup E}MST and the post-peroxide treated {sup E}mMST were also tested in a column configuration using simulated waste solution. The breakthrough curves along with analysis of the sorbent beds at the conclusion of the experiments showed that the peroxide treated

  13. Generalized tonic-clonic seizure

    MedlinePlus

    ... Seizure - grand mal; Grand mal seizure; Seizure - generalized; Epilepsy - generalized seizure ... occur as part of a repeated, chronic illness (epilepsy). Some seizures are due to psychological problems (psychogenic).

  14. Drug therapy of epileptic seizures among adult epileptic outpatients of University of Gondar Referral and Teaching Hospital, Gondar, North West Ethiopia

    PubMed Central

    Birru, Eshetie Melese; Shafi, Miftah; Geta, Mestayet

    2016-01-01

    Objective The aim of this study was to assess the practice of pharmacotherapy of epilepsy and its treatment outcomes in adult epileptic outpatients at the University of Gondar Referral and Teaching Hospital, Gondar, North West Ethiopia. Methods An institution based, retrospective cross-sectional study was conducted from the medical charts of 336 adult epileptic patients at the outpatient epileptic clinic of Neurology Department of University of Gondar Teaching Hospital from May 2014 to April 2015. Reviewing follow-up information from the medical charts was used to evaluate antiepileptic drug (AED) prescribing patterns and treatment outcome. Data were collected by using data collection format and analyzed using SPSS software version 16. Results The most common type of seizure diagnosed was generalized tonic–clonic seizure (n=245, 72.91%). Monotherapy with an AED accounted for 80.35% of the cases, whereas dual therapy and polytherapy with three AED combinations accounted for 16.37% and 3.28%, respectively. The most frequently prescribed AED was phenobarbitone (62.47%) followed by carbamazepine (17.91%). From the total epileptic cases, 277 (82.4%) had well-controlled seizure status in the last three consecutive months. Conclusion Most of the patients were maintained by monotherapy, and largely this was by the older antiepileptic drug, phenobarbitone. Considering the development of pharmacotherapy of epilepsy and other patient related factors, the standard treatment guideline for Ethiopia needs to be revised periodically. PMID:28053533

  15. Feasibility, safety, and preliminary efficacy of Low Amplitude Seizure Therapy (LAP-ST): A proof of concept clinical trial in man.

    PubMed

    Youssef, Nagy A; Sidhom, Emad

    2017-11-01

    Current pulse amplitude used in clinical ECT may be higher than needed. Reducing pulse amplitude may improve focality of the electric field and thus cognitive adverse effects. Here we examine the feasibility, safety, and whether Low Pulse Amplitude Seizure Therapy (LAP-ST, 0.5-0.6A) minimizes cognitive adverse effects while retaining efficacy. Patients with treatment-resistant primary mood (depressive episodes) or psychotic disorders who were clinically indicated to undergo ECT were offered to be enrolled in an open-label study. The study consisted of a full acute course of LAP-ST under standard anesthesia and muscle relaxation. The primary outcome was feasibility of seizure induction. Clinical outcome measures were: time to reorientation (TRO), Mini Mental State Examination, Montgomery Aberg Depression Scale, and Brief Psychiatric Rating Scale, and Clinical Global Impression Scale. Twenty-two patients consented for enrollment in the study. LAP-ST was feasible, and all patients had seizures in the first session. Participants had a quick orientation with median TRO of 4.5min. Treatment was efficacious for both depressive and psychotic symptoms. Relatively small sample size, non-blinded, and no randomization was performed in this initial proof of concept study. This first human preliminary data of a full course of focal LAP-ST demonstrates that seizure induction is feasible. These results, although preliminary, suggest that the LAP-ST compared to the standard ECT techniques may result in less cognitive side effects, but comparable efficacy. Larger studies are needed to replicate these findings. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. "Ghosts in my body": Seizure-like presentation of hypocalcemic tetany secondary to hypomagnesemia in a patient receiving cetuximab therapy for metastatic medulloblastoma.

    PubMed

    Kidwell, Katie S; Kopp, Whitney E; Albano, Edythe A; Brown, Amy E Caruso

    2014-05-01

    Cetuximab, a monoclonal antibody specific for epidermal growth factor receptor, is increasingly used off-label and in early-phase trials for pediatric malignancies. Here, we report a patient with metastatic medulloblastoma receiving therapy with cyclophosphamide, vinblastine, and cetuximab. During evaluation for possible seizures, he was noted to be severely hypocalcemic, hypokalemic, and hypomagnesemic, a consequence of the blockade of renal epidermal growth factor receptor expression. His symptoms rapidly abated with intravenous electrolyte repletion. This case highlights the clinical heterogeneity of tetany and the importance of careful laboratory screening for known adverse effects of chemotherapy, particularly when newer biological agents are used off-study in combination chemotherapeutic regimens.

  17. Combination treatment with flavonoid morin and telomerase inhibitor MST-312 reduces cancer stem cell traits by targeting STAT3 and telomerase

    PubMed Central

    Chung, Seyung S.; Oliva, Bryant; Dwabe, Sami; Vadgama, Jaydutt V.

    2016-01-01

    Colorectal cancer (CRC) is one of the most commonly diagnosed cancers worldwide. The malignant CRC that undergoes metastasis in the advanced stage is usually refractory to existing chemotherapy and shows a poor prognosis. However, to date, efficient targeted-therapy for metastatic CRC is ill-defined. We tested the hypothesis that combined treatment of flavonoid morin and telomerase inhibitor MST-312 may reduce the cancer stem cell (CSC) traits. To characterize CSC phenotype, we performed the CD133/CD44 subpopulation profiling, tumorsphere formation assay, cell invasion assay and wound healing assay. We have examined the augmenting effects of the combined treatment of morin and MST-312 for 5-FU (5-fluorouracil) efficacy in human colorectal cancer. Morin and MST-312 combined treatment reduced CD133 (+) and CD44 (+) subpopulations in human colorectal and breast cancer cells, respectively. Tumorsphere formation and cell invasiveness were decreased with the morin and MST-312 combination treatment. Consistent with these data, morin and MST-312 treatment decreased the wound healing capacity of human breast cancer cells. Stress and apoptosis antibody arrays revealed that there were specific upregulated and downregulated proteins resulting from different treatments. Phosphorylation levels of BAD, p53 and Chk1 were enhanced upon morin/MST-312 treatments in HT-29 cells, whereas caspase-3 cleavage level and expression of IκBα were down-regulated by combined morin/MST-312 treatment in SW620 cells. Finally, morin and MST-312 co-treatment further augmented the 5-FU efficacy, chemosensitizing the 5-FU resistant human colorectal cancer cells. Taken together, our study suggests that novel targeted-therapy can be implemented by using flavonoid morin and telomerase inhibitor MST-312 for improved cancer prognosis. PMID:27279256

  18. 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

  19. DE-FG02-05ER64001 Overcoming the hurdles of multi-step targeting (MST) for effective radioimmunotherapy of solid tumors

    SciTech Connect

    P.I. Steven M. Larson MD Co P.I. Nai-Kong Cheung MD, Ph.D.

    2009-09-21

    The 4 specific aims of this project are: (1) Optimization of MST to increase tumor uptake; (2) Antigen heterogeneity; (3) Characterization and reduction of renal uptake; and (4) Validation in vivo of optimized MST targeted therapy. This proposal focussed upon optimizing multistep immune targeting strategies for the treatment of cancer. Two multi-step targeting constructs were explored during this funding period: (1) anti-Tag-72 and (2) anti-GD2.

  20. ACTH and prednisone in childhood seizure disorders.

    PubMed

    Snead, O C; Benton, J W; Myers, G J

    1983-08-01

    We treated 116 children with ACTH or prednisone. Fifty-two had infantile spasms with hypsarhythmia, and 64 had other types of intractable seizures. ACTH completely controlled seizures in all patients with infantile spasms and hypsarhythmia and 74% of those with other types of seizures. Prednisone controlled 51% of patients with infantile spasms and none with other seizures. Serious side effects were minimal for both drugs, and recurrent seizures occurred in 40 to 50% of patients within 4 to 14 months after completion of therapy.

  1. MST-312 induces G2/M cell cycle arrest and apoptosis in APL cells through inhibition of telomerase activity and suppression of NF-κB pathway.

    PubMed

    Fatemi, Ahmad; Safa, Majid; Kazemi, Ahmad

    2015-11-01

    Telomerase-targeted therapy for cancer has received great attention because telomerase is expressed in almost all cancer cells but is inactive in most normal somatic cells. This study was aimed to investigate the effects of telomerase inhibitor MST-312, a chemically modified derivative of epigallocatechin gallate (EGCG), on acute promyelocytic leukemia (APL) cells. Our results showed that MST-312 exerted a dose-dependent short-term cytotoxic effect on APL cells, with G2/M cell cycle arrest. Moreover, MST-312 induced apoptosis of APL cells in caspase-mediated manner. Telomeric repeat amplification protocol (TRAP) assay revealed significant reduction in telomerase activity of APL cells following short-term exposure to MST-312. Interestingly, MST-312-induced telomerase inhibition was coupled with suppression of NF-κB activity as evidenced by inhibition of IκBα phosphorylation and its degradation and decreased NF-κB DNA binding activity. In addition, gene expression analysis showed downregulation of genes regulated by NF-κB, such as antiapoptotic (survivin, Bcl-2, Mcl-1), proliferative (c-Myc), and telomerase-related (hTERT) genes. Importantly, MST-312 did not show any apoptotic effect in normal human peripheral blood mononuclear cells (PBMCs). In conclusion, our data suggest that dual inhibition of telomerase activity and NF-κB pathway by MST-312 represents a novel treatment strategy for APL.

  2. Frontal Lobe Seizures

    MedlinePlus

    Frontal lobe seizures Overview By Mayo Clinic Staff Frontal lobe seizures are a common form of epilepsy, a ... seizures originate in the front of the brain. Frontal lobe seizures may also be caused by abnormal brain ...

  3. Partial (focal) seizure

    MedlinePlus

    ... Jacksonian seizure; Seizure - partial (focal); Temporal lobe seizure; Epilepsy - partial seizures ... Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff ... Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 101. ...

  4. Dynamics of helical states in MST

    NASA Astrophysics Data System (ADS)

    Munaretto, Stefano; Auriemma, F.; Brower, D.; Chapman, B. E.; den Hartog, D. J.; Ding, W. X.; Duff, J.; Franz, P.; Goetz, J. A.; Holly, D.; Lin, L.; McCollam, K. J.; McGarry, M.; Morton, L.; Nornberg, M. D.; Parke, E.; Sarff, J. S.

    2014-10-01

    The thermal and the magnetic dynamics of quasi-single-helicity (QSH) plasmas evolve independently during the formation and sustainment of the core helical structure. At higher plasma current (and Lundquist number) MST plasmas transition from an axisymmetric multi-helicity state to a QSH state characterized by a strong core helical mode and reduced secondary mode amplitudes. Plasmas in the QSH state tend to wall-lock, often in an orientation that is unfavorable for optimized measurements of the 3D structure using MST's advanced diagnostics. Recently a technique to control the locking position through an applied resonant magnetic perturbation has been developed. Using this technique it is possible to adjust the 3D phase more optimally for specific diagnostics, to study the dynamics of the QSH structure and thermal features. The multi-chord FIR interferometer shows the presence of a density structure for the duration of the QSH state. Measurements of the time evolution of the electron temperature profile using the Thomson Scattering diagnostic reveal that the transition to QSH allows the presence of a 3D thermal structure, but this structure is intermittent. Understanding the mechanism(s) driving these dynamics is the goal of this work. Work supported by the US DOE and NSF.

  5. 73. LIQUID NITROGEN PUMPING STATION ON WEST SIDE OF MST; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    73. LIQUID NITROGEN PUMPING STATION ON WEST SIDE OF MST; NITROGEN EXCHANGERS ON RIGHT. SOUTHWEST CORNER OF MST VISIBLE; ENVIRONMENTAL CURTAIN SWING AND PLATFORM EXTENDED. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  6. 17. VIEW OF INTERIOR, EAST SIDE, DECK LEVEL OF MST. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. VIEW OF INTERIOR, EAST SIDE, DECK LEVEL OF MST. NOTE CANVAS CURTAIN (RIGHT) USED TO COVER SOUTH SIDE OF MST BELOW LOWEST ENVIRONMENTAL DOORS. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  7. 14. VIEW OF MST, FACING SOUTHEAST, AND LAUNCH PAD TAKEN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. VIEW OF MST, FACING SOUTHEAST, AND LAUNCH PAD TAKEN FROM NORTHEAST PHOTO TOWER WITH WINDOW OPEN. FEATURES LEFT TO RIGHT: SOUTH TELEVISION CAMERA TOWER, SOUTHWEST PHOTO TOWER, LAUNCHER, UMBILICAL MAST, MST, AND OXIDIZER APRON. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  8. 29. DETAIL OF OUTLET DUCTS FOR MST AIRCONDITIONING SYSTEM IN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    29. DETAIL OF OUTLET DUCTS FOR MST AIR-CONDITIONING SYSTEM IN NORTHWEST CORNER OF SLC-3W MST STATION 70.5 (LOWEST PAYLOAD SERVICE STATION). NOTE RING ATTACHMENT FOR PERSONNEL SAFETY HARNESS IN LEFT FOREGROUND. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  9. 22. DETAIL OF CHILLERS 1 AND 2 (MST AIRCONDITIONING SYSTEM) ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. DETAIL OF CHILLERS 1 AND 2 (MST AIR-CONDITIONING SYSTEM) INTERIOR, NORTHEAST CORNER, STATION 30, SLC-3W MST - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  10. 1. VIEW OF SOUTHEAST CORNER OF MOBILE SERVICE TOWER (MST). ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. VIEW OF SOUTHEAST CORNER OF MOBILE SERVICE TOWER (MST). CABLE TRAY SHED IN FOREGROUND. MICROWAVE ANTENNAS AND AIR-CONDITIONING PORCH ON EAST SIDE OF MST. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  11. 61. VIEW SOUTH SHOWING MST RAIL, FIRE SUPPRESSION EQUIPMENT (LEFT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    61. VIEW SOUTH SHOWING MST RAIL, FIRE SUPPRESSION EQUIPMENT (LEFT OF RAIL), MST ANCHORING GROMETS (IN LIGHT SQUARE NEAR CENTER OF PHOTO AND IN BACKGROUND NEAR TERMINUS OF RAIL). NORTHWEST CORNER OF LAUNCHER IN LEFT BACKGROUND. BACK OF MAST CONTROL PANEL ON RIGHT. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  12. Randomized Trial of MST and ARC in a Two-Level Evidence-Based Treatment Implementation Strategy

    ERIC Educational Resources Information Center

    Glisson, Charles; Schoenwald, Sonja K.; Hemmelgarn, Anthony; Green, Philip; Dukes, Denzel; Armstrong, Kevin S.; Chapman, Jason E.

    2010-01-01

    Objective: A randomized trial assessed the effectiveness of a 2-level strategy for implementing evidence-based mental health treatments for delinquent youth. Method: A 2 x 2 design encompassing 14 rural Appalachian counties included 2 factors: (a) the random assignment of delinquent youth within each county to a multisystemic therapy (MST) program…

  13. 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…

  14. Febrile seizures

    MedlinePlus

    ... workup, which includes an EEG , head CT , and lumbar puncture (spinal tap) . Further testing may be needed if the child: Is younger than 9 months or older than 5 years Has a brain, nerve, or developmental disorder Had the seizure in only ...

  15. 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…

  16. Seizure prognosis of patients with low-grade tumors.

    PubMed

    Kahlenberg, Cynthia A; Fadul, Camilo E; Roberts, David W; Thadani, Vijay M; Bujarski, Krzysztof A; Scott, Rod C; Jobst, Barbara C

    2012-09-01

    Seizures frequently impact the quality of life of patients with low grade tumors. Management is often based on best clinical judgment. We examined factors that correlate with seizure outcome to optimize seizure management. Patients with supratentorial low-grade tumors evaluated at a single institution were retrospectively reviewed. Using multiple regression analysis the patient characteristics and treatments were correlated with seizure outcome using Engel's classification. Of the 73 patients with low grade tumors and median follow up of 3.8 years (range 1-20 years), 54 (74%) patients had a seizure ever and 46 (63%) had at least one seizure before tumor surgery. The only factor significantly associated with pre-surgical seizures was tumor histology. Of the 54 patients with seizures ever, 25 (46.3%) had a class I outcome at last follow up. There was no difference in seizure outcome between grade II gliomas (astrocytoma grade II, oligodendroglioma grade II, mixed oligo-astrocytoma grade II) and other pathologies (pilocytic astrocytoma, ependymomas, DNET, gangliocytoma and ganglioglioma). Once seizures were established seizure prognosis was similar between different pathologies. Chemotherapy (p=0.03) and radiation therapy (p=0.02) had a positive effect on seizure outcome. No other parameter including significant tumor growth during the follow up period predicted seizure outcome. Only three patients developed new-onset seizures after tumor surgery that were non-perioperative. Anticonvulsant medication was tapered in 14 patients with seizures and 10 had no further seizures. Five patients underwent additional epilepsy surgery with a class I outcome in four. Two patients received a vagal nerve stimulator with >50% seizure reduction. Seizures at presentation are the most important factor associated with continued seizures after tumor surgery. Pathology does not influence seizure outcome. Use of long term prophylactic anticonvulsants is unwarranted. Chemotherapy and

  17. Sexual intimate partner violence as a form of MST: An initial investigation.

    PubMed

    Mercado, Rowena; Foynes, Melissa Ming; Carpenter, S Louisa; Iverson, Katherine M

    2015-11-01

    Military sexual trauma (MST) is known to impact women's health, but little is known about the occurrence of MST perpetrated by a past or current intimate partner. This study identified the occurrence of intimate partner violence (IPV)-related MST in a sample of female veterans. We also examined the associations between MST history (no MST history, IPV-related MST, and MST by a nonintimate partner) and mental and physical health symptoms. Participants were 369 female veteran patients of Department of Veteran Affairs (VA) facilities in the New England region of the United States who completed a larger 2012 mail survey that included validated assessments of MST, posttraumatic stress disorder (PTSD Checklist) and depressive symptoms (CES-D), and general physical and mental health functioning (Short Form-36). Approximately half (49%) of the women in this sample reported a history of MST, of which 27 (15%) were categorized as IPV-related MST. Few differences in health measures were observed among women with IPV-related MST compared with women who experienced MST by a nonintimate partner or women with no MST history. However, women who experienced IPV-related MST had similarly severe health symptoms as women who reported MST by a nonintimate partner and more severe PTSD symptoms than women without a history of MST. Some women veterans have experienced MST at the hands of an intimate partner and face health impacts. This topic warrants additional attention in clinical and research efforts. (c) 2015 APA, all rights reserved).

  18. Archival of Poker Flat MST radar data

    NASA Technical Reports Server (NTRS)

    Riddle, A. C.; Balsley, B. B.; Gage, K. S.

    1986-01-01

    The Poker Flat MST (mesosphere stratosphere troposphere) radar has operated from early 1979 to 1985. The data recorded during that time resides on some 1100 magnetic tapes. A second set containing only the derived parameters of velocity, width and signal to noise of the primary echo at each height, plus the noise spectra, occupies another 250 tapes. While processing to generate the compressed data set does correct some known errors, no attempt has been made to identify or remove spurious echoes. Because the Poker Flat data set is such a unique and valuable resource, a proposal is made to archive the data in forms more useful for analysis. The archived data set would contain only the parameters for significant echoes with contamination from airplanes, unwanted ionospheric returns, frequently aliased Doppler signals and other sources removed. The archived set should be as good or better than the example shown and may occupy only 25 to 50 tapes.

  19. POLG DNA testing as an emerging standard of care before instituting valproic acid therapy for pediatric seizure disorders

    PubMed Central

    Saneto, Russell P.; Lee, Inn-Chi; Koenig, Mary Kay; Bao, Xinhua; Weng, Shao-Wen; Naviaux, Robert K.; Wong, Lee-Jun C.

    2011-01-01

    Purpose To review our clinical experience and determine if there are appropriate signs and symptoms to consider POLG sequencing prior to valproic acid (VPA) dosing in patients with seizures. Methods Four patients who developed VPA-induced hepatotoxicity were examined for POLG sequence variations. A subsequent chart review was used to describe clinical course prior to and after VPA dosing. Results Four patients of multiple different ethnicities, age 3–18 years, developed VPA-induced hepatotoxicity. All were given VPA due to intrac partial seizures. Three of the patients had developed epilepsia partialis continua. The time from VPA exposure to liver failure was between 2 and 3 months. Liver failure was reversible in one patient. Molecular studies revealed homozygous p.R597W or p.A467T mutations in two patients. The other two patients showed compound heterozygous mutations, p.A467T/p.Q68X and p.L83P/p.G888S. Clinical findings and POLG mutations were diagnostic of Alpers–Huttenlocher syndrome. Conclusion Our cases underscore several important findings: POLG mutations have been observed in every ethnic group studied to date; early predominance of epileptiform discharges over the occipital region is common in POLG-induced epilepsy; the EEG and MRI findings varying between patients and stages of the disease; and VPA dosing at any stage of Alpers–Huttenlocher syndrome can precipitate liver failure. Our data support an emerging proposal that POLG gene testing should be considered in any child or adolescent who presents or develops intractable seizures with or without status epilepticus or epilepsia partialis continua, particularly when there is a history of psychomotor regression. PMID:20138553

  20. POLG DNA testing as an emerging standard of care before instituting valproic acid therapy for pediatric seizure disorders.

    PubMed

    Saneto, Russell P; Lee, Inn-Chi; Koenig, Mary Kay; Bao, Xinhua; Weng, Shao-Wen; Naviaux, Robert K; Wong, Lee-Jun C

    2010-04-01

    To review our clinical experience and determine if there are appropriate signs and symptoms to consider POLG sequencing prior to valproic acid (VPA) dosing in patients with seizures. Four patients who developed VPA-induced hepatotoxicity were examined for POLG sequence variations. A subsequent chart review was used to describe clinical course prior to and after VPA dosing. Four patients of multiple different ethnicities, age 3-18 years, developed VPA-induced hepatotoxicity. All were given VPA due to intractable partial seizures. Three of the patients had developed epilepsia partialis continua. The time from VPA exposure to liver failure was between 2 and 3 months. Liver failure was reversible in one patient. Molecular studies revealed homozygous p.R597W or p.A467T mutations in two patients. The other two patients showed compound heterozygous mutations, p.A467T/p.Q68X and p.L83P/p.G888S. Clinical findings and POLG mutations were diagnostic of Alpers-Huttenlocher syndrome. Our cases underscore several important findings: POLG mutations have been observed in every ethnic group studied to date; early predominance of epileptiform discharges over the occipital region is common in POLG-induced epilepsy; the EEG and MRI findings varying between patients and stages of the disease; and VPA dosing at any stage of Alpers-Huttenlocher syndrome can precipitate liver failure. Our data support an emerging proposal that POLG gene testing should be considered in any child or adolescent who presents or develops intractable seizures with or without status epilepticus or epilepsia partialis continua, particularly when there is a history of psychomotor regression. (c) 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  1. Aggravation of atonic seizures by rufinamide: A case report.

    PubMed

    Bektaş, Gonca; Çalışkan, Mine; Aydın, Ali; Pembegül Yıldız, Edibe; Tatlı, Burak; Aydınlı, Nur; Özmen, Meral

    2016-08-01

    Rufinamide is a novel antiepileptic drug used as adjunctive therapy in patients with Lennox-Gastaut syndrome and provides seizure control especially in tonic and atonic seizures. Rufinamide is expected to be effective in intractable epilepsy when atonic and tonic seizures exist. However, rufinamide induced seizure aggravation has been reported in a few patients, which was not associated with a specific type of seizure. A 12-year-old boy with intractable epilepsy had tonic and atonic seizures despite treatment with valproic acid (3000mg/day), levetiracetam (3000mg/day) and clobazam (40mg/day). Rufinamide was administered as adjuvant therapy. After 2weeks on rufinamide, he experienced atonic seizure worsening, and the frequency of epileptic discharges increased. The deterioration in seizure frequency and epileptiform discharges resolved when rufinamide was discontinued. Rufinamide may aggravate atonic seizures in patients with intractable epilepsy. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  2. Dendritic cell MST1 inhibits Th17 differentiation

    PubMed Central

    Li, Chunxiao; Bi, Yujing; Li, Yan; Yang, Hui; Yu, Qing; Wang, Jian; Wang, Yu; Su, Huilin; Jia, Anna; Hu, Ying; Han, Linian; Zhang, Jiangyuan; Li, Simin; Tao, Wufan; Liu, Guangwei

    2017-01-01

    Although the differentiation of CD4+T cells is widely studied, the mechanisms of antigen-presenting cell-dependent T-cell modulation are unclear. Here, we investigate the role of dendritic cell (DC)-dependent T-cell differentiation in autoimmune and antifungal inflammation and find that mammalian sterile 20-like kinase 1 (MST1) signalling from DCs negatively regulates IL-17 producing-CD4+T helper cell (Th17) differentiation. MST1 deficiency in DCs increases IL-17 production by CD4+T cells, whereas ectopic MST1 expression in DCs inhibits it. Notably, MST1-mediated DC-dependent Th17 differentiation regulates experimental autoimmune encephalomyelitis and antifungal immunity. Mechanistically, MST1-deficient DCs promote IL-6 secretion and regulate the activation of IL-6 receptor α/β and STAT3 in CD4+T cells in the course of inducing Th17 differentiation. Activation of the p38 MAPK signal is responsible for IL-6 production in MST1-deficient DCs. Thus, our results define the DC MST1–p38MAPK signalling pathway in directing Th17 differentiation. PMID:28145433

  3. Lipopolysaccharide potentiates hyperthermia-induced seizures

    PubMed Central

    Eun, Baik-Lin; Abraham, Jayne; Mlsna, Lauren; Kim, Min Jung; Koh, Sookyong

    2015-01-01

    Background Prolonged febrile seizures (FS) have both acute and long-lasting effects on the developing brain. Because FS are often associated with peripheral infection, we aimed to develop a preclinical model of FS that simulates fever and immune activation in order to facilitate the implementation of targeted therapy after prolonged FS in young children. Methods The innate immune activator lipopolysaccharide (LPS) was administered to postnatal day 14 rat (200 μg/kg) and mouse (100 μg/kg) pups 2–2.5 h prior to hyperthermic seizures (HT) induced by hair dryer or heat lamp. To determine whether simulation of infection enhances neuronal excitability, latency to seizure onset, threshold temperature and total number of seizures were quantified. Behavioral seizures were correlated with electroencephalographic changes in rat pups. Seizure-induced proinflammatory cytokine production was assessed in blood samples at various time points after HT. Seizure-induced microglia activation in the hippocampus was quantified using Cx3cr1GFP/+ mice. Results Lipopolysaccharide priming increased susceptibility of rats and mice to hyperthemic seizures and enhanced seizure-induced proinflammatory cytokine production and microglial activation. Conclusions Peripheral inflammation appears to work synergistically with hyperthermia to potentiate seizures and to exacerbate seizure-induced immune responses. By simulating fever, a regulated increase in body temperature from an immune challenge, we developed a more clinically relevant animal model of prolonged FS. PMID:26357586

  4. Lipopolysaccharide potentiates hyperthermia-induced seizures.

    PubMed

    Eun, Baik-Lin; Abraham, Jayne; Mlsna, Lauren; Kim, Min Jung; Koh, Sookyong

    2015-08-01

    Prolonged febrile seizures (FS) have both acute and long-lasting effects on the developing brain. Because FS are often associated with peripheral infection, we aimed to develop a preclinical model of FS that simulates fever and immune activation in order to facilitate the implementation of targeted therapy after prolonged FS in young children. The innate immune activator lipopolysaccharide (LPS) was administered to postnatal day 14 rat (200 μg/kg) and mouse (100 μg/kg) pups 2-2.5 h prior to hyperthermic seizures (HT) induced by hair dryer or heat lamp. To determine whether simulation of infection enhances neuronal excitability, latency to seizure onset, threshold temperature and total number of seizures were quantified. Behavioral seizures were correlated with electroencephalographic changes in rat pups. Seizure-induced proinflammatory cytokine production was assessed in blood samples at various time points after HT. Seizure-induced microglia activation in the hippocampus was quantified using Cx3cr1(GFP/+) mice. Lipopolysaccharide priming increased susceptibility of rats and mice to hyperthemic seizures and enhanced seizure-induced proinflammatory cytokine production and microglial activation. Peripheral inflammation appears to work synergistically with hyperthermia to potentiate seizures and to exacerbate seizure-induced immune responses. By simulating fever, a regulated increase in body temperature from an immune challenge, we developed a more clinically relevant animal model of prolonged FS.

  5. 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…

  6. 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…

  7. Mst1 and Mst2 maintain hepatocyte quiescence and suppress the development of hepatocellular carcinoma through inactivation of the Yap1 oncogene

    PubMed Central

    Zhou, Dawang; Conrad, Claudius; Xia, Fan; Park, Ji-Sun; Payer, Bernhard; Yin, Yi; Lauwers, Gregory Y.; Thasler, Wolfgang; Lee, Jeannie T.; Avruch, Joseph; Bardeesy, Nabeel

    2009-01-01

    Hippo-Lats-Yorkie signaling regulates tissue overgrowth and tumorigenesis in Drosophila. We show that the Mst1 and Mst2 protein kinases, the mammalian Hippo orthologs, are cleaved and constitutively activated in the mouse liver. Combined Mst1/2 deficiency in the liver results in loss of inhibitory Ser127 phosphorylation of the Yorkie ortholog, Yap1, massive overgrowth, and hepatocellular carcinoma (HCC). Reexpression of Mst1 in HCC-derived cell lines promotes Yap1 Ser127 phosphorylation and inactivation, and abrogates their tumorigenicity. Notably, Mst1/2 inactivates Yap1 in liver through an intermediary kinase distinct from Lats1/2. Approximately 30% of human HCCs show low Yap1(Ser127) phosphorylation and a majority exhibit loss of cleaved, activated Mst1. Mst1/2 inhibition of Yap1 is an important pathway for tumor suppression in liver relevant to human HCC. Significance The pathways that regulate quiescence and tumor suppression in the liver have not been fully elucidated. We show that the Mst1 and Mst2 kinases are tumor suppressors and regulators of liver size in adults and that negative regulation of the transcriptional coactivator, Yap1, is central to Mst1/2 tumor suppressor function. Loss of both Mst1 and Mst2 is sufficient to initiate hepatocyte proliferation, resulting in dramatic liver overgrowth, resistance to pro-apoptotic stimuli, and the development of HCC. Mst1 and Mst2 promote phosphorylation of Yap1 and thereby suppress its oncogenic activity. Mst1/2 regulation of Yap1 is tissue-specific and, in the liver, involves an Mst1/2-regulated Yap1 kinase distinct from Lats1/2. Significantly, the Mst-Yap1 pathway is disrupted in a substantial fraction of human HCCs. PMID:19878874

  8. Coma and seizures due to severe hyponatremia and water intoxication in an adult with intranasal desmopressin therapy for nocturnal enuresis.

    PubMed

    Odeh, M; Oliven, A

    2001-05-01

    Desmopressin, a synthetic analogue of the antidiuretic hormone, is an effective medication for primary nocturnal enuresis for both children and adults. Its safety is well established. Although it has a favorable side effect profile, because of its pharmacological effect, intranasal desmopressin can rarely induce water intoxication with profound hyponatremia if given without adequate restriction of water intake. The authors describe an adult patient with water intoxication and severe hyponatremia accompanied by loss of consciousness and seizures after 2-day intranasal administration of desmopressin. The present and the previously reported cases emphasize the need for greater awareness of the development of this serious and potentiallyfatal complication. In addition, to adjust the drug to the lowest required dosage, adequate restriction of water intake is recommended, and serum levels of sodium should be measured periodically to allow for early detection of water intoxication and hyponatremia.

  9. 12. VIEW OF NORTH FACE OF MST AND PARTIALLY ERECTED ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. VIEW OF NORTH FACE OF MST AND PARTIALLY ERECTED UMBILICAL MAST. UMBILICAL MAST TRENCH AND DOORS IN FOREGROUND. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  10. 40. VIEW INTO MST CUPOLA FROM STATION 124. DUCT HEATER ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    40. VIEW INTO MST CUPOLA FROM STATION 124. DUCT HEATER FOR STATION 135 AT TOP LEFT OF PHOTOGRAPH. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  11. A long-term noninterventional safety study of adjunctive lacosamide therapy in patients with epilepsy and uncontrolled partial-onset seizures.

    PubMed

    Steinhoff, Bernhard J; Eckhardt, Klaus; Doty, Pamela; De Backer, Marc; Brunnert, Marcus; Schulze-Bonhage, Andreas

    2016-05-01

    This noninterventional, observational, postauthorization safety study (SP0942, NCT00771927) evaluated the incidence of predefined cardiovascular- (CV) and psychiatric-related treatment-emergent adverse events (TEAEs), in patients with epilepsy and uncontrolled partial-onset seizures, when initiating adjunctive therapy with lacosamide or another approved antiepileptic drug (AED) according to standard medical practice. Active recording of predefined TEAEs of interest took place at three-monthly recommended visits for up to 12months. Of 1004 patients who received at least one dose of adjunctive AEDs, 511 initially added lacosamide therapy, 493 added another AED, 69 were ≥65years of age, and 72 took concomitant antiarrhythmic drugs. Patients in the lacosamide cohort had a higher median frequency of partial-onset seizures (6.0 versus 3.5 per 28days) despite taking more concomitant AEDs (84.9% versus 66.9% took ≥2) at baseline. Patients who added lacosamide took a modal dose of 200mg/day over the treatment period (n=501), and 50.1% (256/511) completed 12months of treatment. Fifty-one point nine percent (256/493) of patients who added another AED completed the study, with the most commonly added AED being levetiracetam (28.4%). Four patients (0.8%) in each cohort, all <65years of age, reported predefined CV-related TEAEs. None were considered serious or led to discontinuation. One event each of sinus bradycardia (lacosamide), atrioventricular block first degree (lacosamide), and syncope (other AED) were judged to be treatment-related. Another patient in the other AED cohort reported bradycardia while taking concomitant antiarrhythmic drugs. Predefined psychiatric-related TEAEs were reported by 21 patients (4.1%) in the lacosamide cohort and 27 patients (5.5%) in the other AED cohort. Depression was the most common to be treatment-related (7/11 and 12/18 of patients reporting treatment-related psychiatric TEAEs, respectively). Serious psychiatric-related TEAEs were

  12. Seizure Disorders in Pregnancy

    MedlinePlus

    ... Seizures that cause a loss of consciousness and violent, jerking movements, called grand mal seizures , are especially ... of seizure that causes loss of consciousness and violent, jerking movements. Intrauterine Device: A small device that ...

  13. Epilepsy or seizures - discharge

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000128.htm Epilepsy or seizures - discharge To use the sharing features on this page, please enable JavaScript. You have epilepsy . People with epilepsy have seizures. A seizure is ...

  14. SARAH Domain-Mediated MST2-RASSF Dimeric Interactions

    PubMed Central

    Matallanas, David; Romano, David; Nguyen, Lan K.; Kholodenko, Boris N.; Rosta, Edina; Kolch, Walter

    2016-01-01

    RASSF enzymes act as key apoptosis activators and tumor suppressors, being downregulated in many human cancers, although their exact regulatory roles remain unknown. A key downstream event in the RASSF pathway is the regulation of MST kinases, which are main effectors of RASSF-induced apoptosis. The regulation of MST1/2 includes both homo- and heterodimerization, mediated by helical SARAH domains, though the underlying molecular interaction mechanism is unclear. Here, we study the interactions between RASSF1A, RASSF5, and MST2 SARAH domains by using both atomistic molecular simulation techniques and experiments. We construct and study models of MST2 homodimers and MST2-RASSF SARAH heterodimers, and we identify the factors that control their high molecular stability. In addition, we also analyze both computationally and experimentally the interactions of MST2 SARAH domains with a series of synthetic peptides particularly designed to bind to it, and hope that our approach can be used to address some of the challenging problems in designing new anti-cancer drugs. PMID:27716844

  15. Transcriptome profiling of hippocampal CA1 after early-life seizure-induced preconditioning may elucidate new genetic therapies for epilepsy.

    PubMed

    Friedman, L K; Mancuso, J; Patel, A; Kudur, V; Leheste, J R; Iacobas, S; Botta, J; Iacobas, D A; Spray, D C

    2013-07-01

    Injury of the CA1 subregion induced by a single injection of kainic acid (1 × KA) in juvenile animals (P20) is attenuated in animals with two prior sustained neonatal seizures on P6 and P9. To identify gene candidates involved in the spatially protective effects produced by early-life conditioning seizures we profiled and compared the transcriptomes of CA1 subregions from control, 1 × KA- and 3 × KA-treated animals. More genes were regulated following 3 × KA (9.6%) than after 1 × KA (7.1%). Following 1 × KA, genes supporting oxidative stress, growth, development, inflammation and neurotransmission were upregulated (e.g. Cacng1, Nadsyn1, Kcng1, Aven, S100a4, GFAP, Vim, Hrsp12 and Grik1). After 3 × KA, protective genes were differentially over-expressed [e.g. Cat, Gpx7, Gad1, Hspa12A, Foxn1, adenosine A1 receptor, Ca(2+) adaptor and homeostasis proteins, Cacnb4, Atp2b2, anti-apoptotic Bcl-2 gene members, intracellular trafficking protein, Grasp and suppressor of cytokine signaling (Socs3)]. Distinct anti-inflammatory interleukins (ILs) not observed in adult tissues [e.g. IL-6 transducer, IL-23 and IL-33 or their receptors (IL-F2 )] were also over-expressed. Several transcripts were validated by real-time polymerase chain reaction (QPCR) and immunohistochemistry. QPCR showed that casp 6 was increased after 1 × KA but reduced after 3 × KA; the pro-inflammatory gene Cox1 was either upregulated or unchanged after 1 × KA but reduced by ~70% after 3 × KA. Enhanced GFAP immunostaining following 1 × KA was selectively attenuated in the CA1 subregion after 3 × KA. The observed differential transcriptional responses may contribute to early-life seizure-induced pre-conditioning and neuroprotection by reducing glutamate receptor-mediated Ca(2+) permeability of the hippocampus and redirecting inflammatory and apoptotic pathways. These changes could lead to new genetic therapies for epilepsy. © 2013 Federation of European Neuroscience

  16. Electron Bernstein Wave Studies in MST

    SciTech Connect

    Seltzman, Andrew H.; Anderson, Jay K.; Nonn, Paul D.; Kauffold, Jason X.; Forest, Cary B.; Diem, Stephanie J.

    2011-12-23

    The overdense plasma in an RFP prevents electromagnetic waves from propagating past the edge, however use of the electron Bernstein wave (EBW) has the potential to heat and drive current in the plasma. MHD simulations have demonstrated that resistive tearing mode stability is very sensitive to gradients in the edge current density profile allowing EBW to potentially be a stabilizing influence. A new MW level experiment is being commissioned on MST to evaluate the potential use of the EBW for current profile control on the RFP. The development of new equipment includes a 5.5 GHz klystron driven by a novel switchmode power supply. A quartz window has been constructed and coupling with a cylindrical molybdenum wave guide antenna has been studied. Due to the steep edge density gradient in the RFP, it is possible to efficiently couple to the EBW with O or X mode launch. The EBW is strongly damped at the electron cyclotron resonance where it couples to the electron gyromotion and alters the electron distribution. Either Fisch-Boozer or Ohkawa current drive mechanisms can be activated to drive off axis current in the plasma. Preliminary experiments have been performed to verify high power coupling and understand heating via observed x-ray emission when compared to Fokker-Plank modeling in CQL3D.

  17. Optimum coding techniques for MST radars

    NASA Technical Reports Server (NTRS)

    Sulzer, M. P.; Woodman, R. F.

    1986-01-01

    The optimum coding technique for MST (mesosphere stratosphere troposphere) radars is that which gives the lowest possible sidelobes in practice and can be implemented without too much computing power. Coding techniques are described in Farley (1985). A technique mentioned briefly there but not fully developed and not in general use is discussed here. This is decoding by means of a filter which is not matched to the transmitted waveform, in order to reduce sidelobes below the level obtained with a matched filter. This is the first part of the technique discussed here; the second part consists of measuring the transmitted waveform and using it as the basis for the decoding filter, thus reducing errors due to imperfections in the transmitter. There are two limitations to this technique. The first is a small loss in signal to noise ratio (SNR), which usually is not significant. The second problem is related to incomplete information received at the lowest ranges. An appendix shows a technique for handling this problem. Finally, it is shown that the use of complementary codes on transmission and nonmatched decoding gives the lowest possible sidelobe level and the minimum loss in SNR due to mismatch.

  18. 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…

  19. 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…

  20. Prognostic significance of MST1R dysregulation in renal cell tumors

    PubMed Central

    Pires-Luís, Ana S; Vieira-Coimbra, Márcia; Ferreira, Maria João; Ramalho-Carvalho, João; Costa-Pinheiro, Pedro; Antunes, Luís; Dias, Paula C; Lobo, Francisco; Oliveira, Jorge; Graça, Inês; Henrique, Rui; Jerónimo, Carmen

    2016-01-01

    Macrophage stimulating 1 receptor (MST1R) is a C-MET proto-oncogene family receptor tyrosine kinase. Promoter methylation patterns determine transcription of MST1R variants as hypermethylation of a region upstream of transcription start site (TSS) is associated with lack of MST1R long transcript (MST1R long) and expression of a short transcript with oncogenic potential. Thus, we aimed to investigate MST1R variant transcript regulation in renal cell tumors (RCT) and assess their prognostic potential. We found, in a series of 120 RCT comprising the four main subtypes (clear cell, papillary and chromophobe renal cell carcinoma, and oncocytoma), that higher methylation levels close to TSS were associated with total MST1R expression levels (MST1R total) in primary tumors (p=0.049) and renal cancer cell lines. After demethylating treatment, MST1R long/MST1R total ratio increased, as expected, in two renal cell carcinoma cell lines tested. However, in primary tumors with hypermethylation upstream of TSS, a decrease in MST1R long/MST1R total ratio was not detected, although higher expression ratio of nuclear factor-κB was apparent. Furthermore, survival analysis demonstrated that MST1R long/MST1R total ratio was independently associated with shorter disease-specific and disease-free survival, whereas MST1R total expression associated with shorter disease-specific survival. In conclusion, although promoter methylation patterns seem to determine MST1R global transcription regulation in renal cell carcinoma, other mechanisms might contribute to deregulate MST1R variant expression in RCT. Nevertheless, MST1R total expression and MST1R long/MST1R total ratio modulate the biological and clinical aggressiveness of renal cell carcinoma, as depicted by its prognostic significance, a finding that requires validation in a larger independent series. PMID:27648366

  1. LEACHING OF TITANIUM FROM MONOSODIUM TITANATE AND MODIFIED MST

    SciTech Connect

    Taylor-Pashow, K.; Fondeur, F.; Fink, S.

    2012-08-01

    Analysis of a fouled coalescer and pre-filters from Actinide Removal Process/Modular Caustic Side Solvent Extraction Unit (ARP/MCU) operations showed evidence of Ti containing solids. Based on these results a series of tests were planned to examine the extent of Ti leaching from monosodium titanate (MST) and modified monosodium titanate (mMST) in various solutions. The solutions tested included a series of salt solutions with varying free hydroxide concentrations, two sodium hydroxide concentrations, 9 wt % and 15 wt %, nitric and oxalic acid solutions. Overall, the amount of Ti leached from the MST and mMST was much greater in the acid solutions compared to the sodium hydroxide or salt solutions, which is consistent with the expected trend. The leaching data also showed that increasing hydroxide concentration, whether pure NaOH solution used for filter cleaning in ARP or the waste salt solution, increased the amount of Ti leached from both the MST and mMST. For the respective nominal contact times with the MST solids - for filter cleaning or the normal filter operation, the dissolved Ti concentrations are comparable suggesting either cause may contribute to the increased Ti fouling on the MCU coalescers. Tests showed that Ti containing solids could be precipitated from solution after the addition of scrub acid and a decrease in temperature similar to expected in MCU operations. FTIR analysis of these solids showed some similarity to the solids observed on the fouled coalescer and pre-filters. Although only a cursory study, this information suggests that the practice of increasing free hydroxide in feed solutions to MCU as a mitigation to aluminosilicate formation may be offset by the impact of formation of Ti solids in the overall process. Additional consideration of this finding from MCU and SWPF operation is warranted.

  2. EDITORIAL: MST Best Paper Award for 2004

    NASA Astrophysics Data System (ADS)

    Gill, Patrick

    2005-12-01

    For the last 13 years, Measurement Science and Technology has awarded a Best Paper prize. The Editorial Board of the journal believes that such a prize is an opportunity to thank authors for submitting their work, and serves as an integral part of the on-going quality review of the journal. An Editorial Board working party, comprising Patrick Gill (Chairman), David Birch and Ralph Tatam undertook the task of selecting as Best Paper 2004 a single contributed paper describing new and significant work, well aligned with the measurement scope of the journal, and presented in clear and rigorous form. They received a number of recommendations from the Editorial and International Advisory Board Members, and they would like to record their thanks to the Members for these recommendations, as they form an all-important first stage in the assessment process. There were responses from some five Board Members. In total, there were 16 papers nominated, plus another six from the working party. All these papers had quality ratings of 2 or higher from the referees, and note was also taken of the total electronic accesses for those papers subsequently short-listed. Review Articles, and papers that included a Board Member as an author, were automatically excluded. From the submitted nominations and working party deliberations, a short list of two papers was drawn up. The winning paper was then selected on the totality of criteria. Thus the paper recommended by the working party for the MST Best Paper Award for 2004 is: 'Adsorptive pressure-sensitive coatings on porous anodised aluminium' by Masaharu Kameda, Norikazu Tezuka, Tomohiro Hangai, Keisuke Asai, Kazuyuki Nakakita and Yutaka Amao, 15 489-500 (2004) This paper describes a novel pressure sensor based on a luminescent coating applied to a porous anodized aluminium layer, with application to the measurement of fluctuating pressures on short timescales with high spatial resolution. The research has particular application to

  3. Can Seizure-Alert Dogs predict seizures?

    PubMed

    Brown, Stephen W; Goldstein, Laura H

    2011-12-01

    An index observation where a dog was trained to alert to, as well as respond to, human tonic-clonic seizures led to further research and refinement of training techniques. This was followed by anecdotal reports of pet dogs spontaneously anticipating human epileptic seizures. An industry has since developed training Seizure-Alert Dogs (SADs) to give humans warnings of their seizures. In some cases this has been accompanied by a reduction in seizure frequency. SADs may be trained along with the person with epilepsy, responding specifically to that person's seizures, or may be trained separately. Recent sceptical reports of non-epileptic seizures in some people with SADs have cast doubt on dogs' ability to anticipate true epileptic seizures. This may reflect selection criteria for training programmes as well as training methods used, but does not necessarily indicate that SADs might not be able to predict epileptic seizures. Whether the seizures are epileptic or non-epileptic, it is speculated that SADs probably alert to subtle pre-ictal human behaviour changes, but may also be sensitive to heart rate or olfactory cues. As yet, however, no rigorous data exist as to whether seizure prediction by SADS is better than chance, and what false positive and negative prediction rates might be.

  4. Tardive seizure: a case report.

    PubMed

    Williams, Adedapo; Adetunji, Babatunde; Odulate, Adeola

    2006-12-01

    Electroconvulsive therapy remains the best option for treatment-resistant depressive episodes. A rare, but potentially dangerous, complication is tardive seizures, which occur after the patient has already stopped convulsing from the electroconvulsive therapy and has recovered full consciousness. We have decided to report this case, which many psychiatrists and psychiatry residents may not be familiar with, to heighten the awareness of the condition because it has ramifications in terms of safe management of the patients concerned.

  5. Selective frontal, parietal, and temporal networks in generalized seizures.

    PubMed

    Blumenfeld, Hal; Westerveld, Michael; Ostroff, Robert B; Vanderhill, Susan D; Freeman, Jason; Necochea, Alexandro; Uranga, Paula; Tanhehco, Tasha; Smith, Arien; Seibyl, John P; Stokking, Rik; Studholme, Colin; Spencer, Susan S; Zubal, I George

    2003-08-01

    Are "generalized" seizures truly generalized? Generalized tonic-clonic seizures are classified as either secondarily generalized with local onset or primarily generalized, without known focal onset. In both types of generalized seizures widespread regions of the nervous system engage in abnormally synchronous and high-frequency neuronal firing. However, emerging evidence suggests that all neurons are not homogeneously involved; specific nodes within the network may be crucial for the propagation and behavioral manifestations of generalized tonic-clonic seizures. Study of human tonic-clonic seizures has been limited by problems with patient movement and variable seizure types. To circumvent these problems, we imaged generalized tonic-clonic seizures during electroconvulsive therapy, in which seizure type and timing are well controlled. (99m)Tc-hexamethylpropylene amine oxime injections during seizures provide a "snapshot" of cerebral blood flow that can be imaged by single photon emission computed tomography (SPECT) after seizure termination. Here we show that focal regions of frontal and parietal association cortex show the greatest relative signal increases. Involvement of the higher-order association cortex may explain the profound impairment of consciousness seen in generalized seizures. In addition, focal involvement of the dominant temporal lobe was associated with impaired retrograde verbal memory. Similar focal increases were also seen in imaging of spontaneous secondarily generalized tonic-clonic seizures. Relative sparing of many brain regions during both spontaneous and induced seizures suggests that specific networks may be more important than others in so-called generalized seizures.

  6. [Efficacy and safety of levetiracetam as adjunctive therapy in Japanese children with uncontrolled partial-onset seizures: multicenter and open-label study (N01223), short term evaluation].

    PubMed

    Nakamura, Hidefumi; Osawa, Makiko; Yokoyama, Terumichi; Yoshida, Katsumi; Suzuki, Atsushi

    2013-09-01

    A multicenter, open-label, single-armed study (N01223) was conducted to evaluate efficacy and safety of levetiracetam (LEV) as an add-on therapy in Japanese pediatric patients with uncontrolled partial-onset seizures (POS). A total of 73 children aged 4-15 years (mean±SD=10.1±3.4 years) were enrolled in the study, which consisted of an 8-week baseline period and a 14-week treatment period, including a 4-week titration period. A historical placebo control from a pivotal overseas pediatric study in POS add-on therapy was used. A 16.3% median percent reduction from the baseline in POS was observed in this placebo control. Therefore, in the present study, this value (16.3%) was chosen as the predefined threshold for the lower limit of the 95% confident interval (95% CI) of the median percent reduction from the baseline for LEV. In the present study, the percentage reduction (95% CI) in POS during the treatment period was 43.21% (26.19-52.14%), indicating a beneficial impact of LEV. The incidences of treatment-emergent adverse events (TEAEs) and adverse drug reactions (ADRs) were 82.2% (60/73 cases) and 56.2% (41/73 cases), respectively. The most common TEAEs were somnolence, nasopharyngitis, upper respiratory tract infection, and pyrexia. Frequent ADRs (more than 3%) were somnolence and feeling jittery. No serious TEAE or death was reported during the study. Our results suggested that adjunctive therapy with LEV is clinically efficacious and well tolerated in Japanese children with uncontrolled POS.

  7. Long-term safety and seizure outcome in Japanese patients with Lennox-Gastaut syndrome receiving adjunctive rufinamide therapy: An open-label study following a randomized clinical trial.

    PubMed

    Ohtsuka, Yoko; Yoshinaga, Harumi; Shirasaka, Yukiyoshi; Takayama, Rumiko; Takano, Hiroki; Iyoda, Kuniaki

    2016-03-01

    To evaluate the long-term safety and seizure outcome in Japanese patients with Lennox-Gastaut syndrome (LGS) receiving adjunctive rufinamide therapy. We conducted an open-label extension study following a 12-week multicenter, randomized, double-blind, placebo-controlled study of adjunctive rufinamide therapy in Japanese patients with LGS. Fifty-four patients participated in the extension study. Seizure frequency was evaluated until 52 weeks after the start of the extension study. Adverse events (AEs) were evaluated throughout both studies. Of the 54 patients, 41 (75.9%) completed the extension study. The median duration of exposure to rufinamide was 818.0 days in all 54 patients, and 38 patients (70.4%) received rufinamide for 2 years or more. The median percent change in the frequency of tonic-atonic seizures relative to the frequency at the start of the double-blind study was -39.3% (12 weeks), -40.6% (24 weeks), -46.8% (32 weeks), -47.6% (40 weeks), and -36.1% (52 weeks). Reduction of total seizure frequency was also maintained until 52 weeks. Frequent treatment-related AEs were somnolence (20.4%), decreased appetite (16.7%), transient seizure aggravation including status epilepticus (13.0%), vomiting (11.1%), and constipation (11.1%). Adverse events were mild or moderate, except for transient seizure aggravation in three patients. Adverse events resulting in discontinuation of rufinamide were decreased appetite, drug eruption, and worsening of underlying autism. When clinically notable weight loss was defined as a decrease ≥ 7% relative to baseline, 22 patients (40.7%) experienced weight loss at least once during long-term observation, although weight loss was reported as an AE in only three patients. This study demonstrated a long-term benefit of rufinamide as adjunctive therapy for Japanese patients with LGS. Exacerbation of seizures and decreased appetite/weight loss should be monitored carefully. Copyright © 2016 The Authors. Published by Elsevier B

  8. Management of Adult Onset Seizures.

    PubMed

    Crepeau, Amy Z; Sirven, Joseph I

    2017-02-01

    Epilepsy is a common yet heterogeneous disease. As a result, management often requires complex decision making. The ultimate goal of seizure management is for the patient to have no seizures and no considerable adverse effects from the treatment. Antiepileptic drugs are the mainstay of therapy, with more than 20 medications currently approved in the United States. Antiepileptic drug selection requires an understanding of the patient's epilepsy, along with consideration of comorbidities and potential for adverse events. After a patient has failed at least 2 appropriate antiepileptic drugs, they are determined to be medically refractory. At this time, additional therapy, including dietary, device, or surgical treatments, need to be considered, typically at a certified epilepsy center. All these treatments require consideration of the potential for seizure freedom, balanced against potential adverse effects, and can have a positive effect on seizure control and quality of life. This review article discussed the treatment options available for adults with epilepsy, including medical, surgical, dietary, and device therapies. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  9. Maximizing MST's inductive capability with a Bp programmable power supply

    NASA Astrophysics Data System (ADS)

    Chapman, B. E.; Holly, D. J.; Jacobson, C. M.; McCollam, K. J.; Morin, J. C.; Sarff, J. S.; Squitieri, A.

    2016-10-01

    A major goal of the MST program is the advancement of inductive control for the development of both the RFP's fusion potential and, synergistically, the predictive capability of fusion science. This entails programmable power supplies (PPS's) for the Bt and Bp circuits. A Bt PPS is already in place, allowing advanced RFP operation and the production of tokamak plasmas, and a Bp PPS prototype is under construction. To explore some of the new capabilities to be provided by the Bp PPS, the existing Bt PPS has been temporarily connected to the Bp circuit. One key result is new-found access to very low Ip (20 kA) and very low Lundquist number, S (104). At this low S, simulation of RFP plasmas with the MHD code NIMROD is readily achievable, and work toward validation of extended MHD models using NIMROD is underway with direct comparisons to these MST plasmas. The full Bp PPS will also provide higher Ip and S than presently possible, allowing MST to produce plasmas with S spanning as much as five orders of magnitude, a dramatic extension of MST's capability. In these initial tests, the PPS has also increased five-fold MST's Ip flattop duration, to about 100 ms. This, coupled with the recently demonstrated PPS ability to drive large-amplitude sinusoidal oscillations in Ip, will allow tests of extended-duration oscillating field current drive, the goal of which is ac sustainment of a quasi-dc plasma current. Work supported by US DOE.

  10. Seizure characteristics in Pallister-Killian syndrome.

    PubMed

    Candee, Meghan S; Carey, John C; Krantz, Ian D; Filloux, Francis M

    2012-12-01

    Pallister-Killian syndrome (PKS) is a congenital disorder attributed to supernumerary isochromosome 12p mosaicism. Craniofacial dysmorphism, learning impairment and seizures are considered cardinal features. However, little is known regarding the seizure and epilepsy patterns in PKS. To better define the prevalence and spectrum of seizures in PKS, we studied 51 patients (39 male, 12 female; median age 4 years and 9 months; age range 7 months to 31 years) with confirmed 12p tetrasomy. Using a parent-based structured questionnaire, we collected data regarding seizure onset, frequency, timing, semiology, and medication therapy. Patients were recruited through our practice, at PKS Kids family events, and via the PKS Kids website. Epilepsy occurred in 27 (53%) with 23 (85%) of those with seizures having seizure onset prior to 3.5 years of age. Mean age at seizure onset was 2 years and 4 months. The most common seizure types were myoclonic (15/27, 56%), generalized convulsions (13/27, 48%), and clustered tonic spasms (similar to infantile spasms; 8/27, 30%). Thirteen of 27 patients with seizures (48%) had more than one seizure type with 26 out of 27 (96%) ever having taken antiepileptic medications. Nineteen of 27 (70%) continued to have seizures and 17/27 (63%) remained on antiepileptic medication. The most commonly used medications were: levetiracetam (10/27, 37%), valproic acid (10/27, 37%), and topiramate (9/27, 33%) with levetiracetam felt to be "most helpful" by parents (6/27, 22%). Further exploration of seizure timing, in-depth analysis of EEG recordings, and collection of MRI data to rule out confounding factors is warranted.

  11. Evaluation of first nonfebrile seizures.

    PubMed

    Wilden, Jessica A; Cohen-Gadol, Aaron A

    2012-08-15

    Nonfebrile seizures may indicate underlying disease or epilepsy. The patient history can often distinguish epileptic seizures from nonepileptic disorders by identifying the events directly preceding the convulsion, associated conditions, and details of the seizure, including triggers, length, and type of movements. Laboratory testing, lumbar puncture, and neuroimaging may be indicated depending on the presentation, suspected etiology, and patient's age. Electroencephalography should be performed 24 to 48 hours after a first seizure because of its substantial yield and ability to predict recurrence. Neuroimaging is recommended for adults, infants, and children who have cognitive or motor developmental delay or a focal seizure. Neuroimaging may be scheduled on an outpatient basis for patients with stable vital signs who are awake and have returned to neurologic baseline. Emergent neuroimaging should be performed in patients with persistent decreased mental status or a new focal neurologic abnormality. Although magnetic resonance imaging is generally preferred to head computed tomography because of its greater sensitivity for intracranial pathology, computed tomography should be performed if intracranial bleeding is suspected because of recent head trauma, coagulopathy, or severe headache. Treatment with an antiepileptic drug after a first seizure does not prevent epilepsy in the long term, but it decreases the short-term likelihood of a second seizure. Adults with an unremarkable neurologic examination, no comorbidities, and no known structural brain disease who have returned to neurologic baseline do not need to be started on antiepileptic therapy. Treatment decisions should weigh the benefit of decreased short-term risk of recurrence against the potential adverse effects of antiepileptic drugs.

  12. [Seizures revealing phosphocalcic metabolism abnormalities].

    PubMed

    Hmami, F; Chaouki, S; Benmiloud, S; Souilmi, F Z; Abourazzak, S; Idrissi, M; Atmani, S; Bouharrou, A; Hida, M

    2014-01-01

    Hypocalcemia due to hypoparathyroidism produces a broad spectrum of clinical manifestations, but overt symptoms may be sparse. One unusual presentation is onset or aggravation of epilepsy in adolescence revealing hypoparathyroidism. This situation can lead to delayed diagnosis, with inefficacity of the antiepileptic drugs. We report five cases of adolescence-onset epilepsy with unsuccessful antiepileptic therapy, even with gradually increasing dose. Physical examination revealed signs of hypocalcemia, confirmed biologically. Full testing disclosed the origin of the seizures: hypoparathyroidism in three patients and pseudohypoparathyroidism in the other two. In four of five patients, computed tomography showed calcification of the basal ganglia, defining Fahr's syndrome. The patients were treated with oral calcium and active vitamin D (1-alphahydroxy vitamin D3). Seizure frequency progressively decreased and serum calcium levels returned to normal. These cases illustrate the importance of the physical examination and of routine serum calcium assay in patients with new-onset epileptic seizures in order to detect hypocalcemia secondary to hypoparathyroidism.

  13. A 33-year-old patient with human immunodeficiency virus on antiretroviral therapy with efavirenz-induced complex partial seizures: a case report.

    PubMed

    Shehu, Nathan Yakubu; Ojeh, Victor; Osaigbovo, Godwin; Agaba, Patricia; Agbaji, Oche

    2016-04-13

    Efavirenz is a commonly prescribed antiretroviral drug that is largely well tolerated. However, seizure disorder is a rare side effect. Prompt identification and immediate replacement of efavirenz with an alternative drug would effectively stop the seizures. To the best of our knowledge, we present the first reported case in the literature of complex partial seizures arising due to efavirenz. We report a case of a 33-year-old Nigerian man treated with an efavirenz-based antiretroviral regimen for human immunodeficiency virus infection. He presented with seizures soon after commencement of antiretroviral drugs. His magnetic resonance imaging results were unremarkable. His blood levels of sodium, glucose, urea, and creatinine were within normal limits. However, his electroencephalogram showed intermittent bursts of high-voltage sharp waves and spikes bilaterally over frontotemporoparietal regions, a finding consistent with complex partial seizures. His efavirenz plasma level was 209.55 μg/ml. His seizures stopped following a switch to a non-efavirenz-based regimen. This report brings to light the occurrence of complex partial seizures in patients on efavirenz. It also demonstrates the effective resolution of seizures when efavirenz treatment is replaced with a non-efavirenz-based regimen.

  14. 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.

  15. Properties of echo spectra observed by MST radars

    NASA Technical Reports Server (NTRS)

    Wakasugi, K.

    1983-01-01

    Turbulent scatter and Fresnel reflection are the fundamental echoing mechanisms to interpret the signals observed by Mesosphere-stratosphere-troposphere (MST) radars. Turbulent scattered echoes provide information about the turbulence structure and mean flow of the atmosphere. Observational results with VHF MST radars, however, show the importance of Fresnel reflection due to the infinite gradient of reflectivity at the edges of a scattering layer. This condition is excluded for the weak fluctuation models but it is still possible to include the observed aspect sensitivity by assuming an anisotropic structure of fluctuations. Another explanation of the aspect sensitivity observed by MST radars is advanced. Spectral estimates by the widely used periodogram were related to a four-dimensional spectrum of atmospheric fluctuations with anisotropic structure. Effects of the radar system such as antenna beam width, beam direction and Fast Fourier Transformations (FFT) data length were discussed for the anisotropic turbulent atmosphere. Echo parameters were also estimated.

  16. The Future of Seizure Prediction and Intervention: Closing the loop

    PubMed Central

    Nagaraj, Vivek; Lee, Steven; Krook-Magnuson, Esther; Soltesz, Ivan; Benquet, Pascal; Irazoqui, Pedro; Netoff, Theoden

    2014-01-01

    The ultimate goal of epilepsy therapies is to provide seizure control for all patients while eliminating side effects. Improved specificity of intervention through on-demand approaches may overcome many of the limitations of current intervention strategies. This article reviews progress in seizure prediction and detection, potential new therapies to provide improved specificity, and devices to achieve these ends. Specifically, we discuss 1) potential signal modalities and algorithms for seizure detection and prediction, 2) closed-loop intervention approaches, and 3) hardware for implementing these algorithms and interventions. Seizure prediction and therapies maximize efficacy while minimizing side-effects through improved specificity may represent the future of epilepsy treatments. PMID:26035672

  17. Assessment of performing an MST strike in Tank 21H

    SciTech Connect

    Poirier, Michael R.

    2014-09-29

    Previous Savannah River National Laboratory (SRNL) tank mixing studies performed for the Small Column Ion Exchange (SCIX) project have shown that 3 Submersible Mixer Pumps (SMPs) installed in Tank 41 are sufficient to support actinide removal by MST sorption as well as subsequent resuspension and removal of settled solids. Savannah River Remediation (SRR) is pursuing MST addition into Tank 21 as part of the Large Tank Strike (LTS) project. The preliminary scope for LTS involves the use of three standard slurry pumps (installed in N, SE, and SW risers) in a Type IV tank. Due to the differences in tank size, internal interferences, and pump design, a separate mixing evaluation is required to determine if the proposed configuration will allow for MST suspension and strontium and actinide sorption. The author performed the analysis by reviewing drawings for Tank 21 [W231023] and determining the required cleaning radius or zone of influence for the pumps. This requirement was compared with previous pilot-scale MST suspension data collected for SCIX that determined the cleaning radius, or zone of influence, as a function of pump operating parameters. The author also reviewed a previous Tank 50 mixing analysis that examined the ability of standard slurry pumps to suspend sludge particles. Based on a review of the pilot-scale SCIX mixing tests and Tank 50 pump operating experience, three standard slurry pumps should be able to suspend sludge and MST to effectively sorb strontium and actinides onto the MST. Using the SCIX data requires an assumption about the impact of cooling coils on slurry pump mixing. The basis for this assumption is described in this report. Using the Tank 50 operating experience shows three standard slurry pumps should be able to suspend solids if the shear strength of the settled solids is less than 160 Pa. Because Tank 21 does not contain cooling coils, the shear strength could be larger.

  18. Seizures in adults with bacterial meningitis.

    PubMed

    Zoons, E; Weisfelt, M; de Gans, J; Spanjaard, L; Koelman, J H T M; Reitsma, J B; van de Beek, D

    2008-05-27

    conditions. The high associated mortality rate warrants a low threshold for starting anticonvulsant therapy in those with clinical suspicion of a seizure.

  19. System aspects of the Indian MST radar facility

    NASA Technical Reports Server (NTRS)

    Viswanathan, G.

    1986-01-01

    One of the major objectives of the Indian Middle Atmosphere Program is to investigate the motions of the middle atmosphere on temporal and spatial scales and the interaction between the three height regions of the middle atmosphere. Realizing the fact that radar technique has proven to be a very powerful tool for the study of Earth atmosphere, the Indian Middle Atmosphere Program has recommended establishing a mesosphere-stratosphere-troposphere (MST) radar as a national facility for atmospheric research. The major landmarks in this attempt to setup the MST radar as a national facility are described.

  20. Treatment of partial seizures and seizure-like activity with felbamate in six dogs.

    PubMed

    Ruehlmann, D; Podell, M; March, P

    2001-08-01

    Six dogs with partial seizures or partial seizure-like activity were treated with the antiepileptic drug felbamate between 1993 and 1998. All dogs had a history and results of diagnostic testing suggestive of either primary (idiopathic) or occult secondary epilepsy. Dogs ranged between four months and eight years of age at the onset of seizure activity. The median time period between onset of the first seizure and the start of felbamate therapy was 3.8 months (range 0.75 to 36 months). Median duration of therapy was nine months (range two to 22 months). All dogs experienced a reduction in seizure frequency after felbamate administration. Median total number of seizures post-treatment was two (range 0 to 9). Two dogs had an immediate and prolonged cessation of seizure activity. Steady-state trough serum felbamate concentrations measured at two weeks, and one, 12 and 22 months after the commencement of therapy in four dogs ranged between 13 and 55 mg/litre (median 35 mg/litre). Reversible haematological adverse effects were detected in two dogs, with one dog developing concurrent keratoconjunctivitis sicca. These results suggest that felbamate can be an effective antiepileptic drug without life-threatening complications when used as monotherapy for partial seizures in the dog.

  1. Neonatal Seizures: An Update on Mechanisms and Management

    PubMed Central

    Jensen, Frances E.

    2010-01-01

    The lifespan risk of seizures is highest in the neonatal period. Currently used therapies have limited efficacy. Although the treatment of neonatal seizures has not significantly changed in the last several decades, there has been substantial progress in understanding developmental mechanisms that influence seizure generation and responsiveness to anticonvulsants. Here we provide an overview of current approaches to the diagnosis and treatment of neonatal seizures, identifying some of the recent insights about the pathophysiology of neonatal seizures that may provide the foundation for better treatment. PMID:19944840

  2. Treatment of drug-induced seizures.

    PubMed

    Chen, Hsien-Yi; Albertson, Timothy E; Olson, Kent R

    2016-03-01

    Seizures are a common complication of drug intoxication, and up to 9% of status epilepticus cases are caused by a drug or poison. While the specific drugs associated with drug-induced seizures may vary by geography and change over time, common reported causes include antidepressants, stimulants and antihistamines. Seizures occur generally as a result of inadequate inhibitory influences (e.g., gamma aminobutyric acid, GABA) or excessive excitatory stimulation (e.g. glutamate) although many other neurotransmitters play a role. Most drug-induced seizures are self-limited. However, status epilepticus occurs in up to 10% of cases. Prolonged or recurrent seizures can lead to serious complications and require vigorous supportive care and anticonvulsant drugs. Benzodiazepines are generally accepted as the first line anticonvulsant therapy for drug-induced seizures. If benzodiazepines fail to halt seizures promptly, second line drugs include barbiturates and propofol. If isoniazid poisoning is a possibility, pyridoxine is given. Continuous infusion of one or more anticonvulsants may be required in refractory status epilepticus. There is no role for phenytoin in the treatment of drug-induced seizures. The potential role of ketamine and levetiracetam is promising but not established.

  3. MST50 Is Involved in Multiple MAP Kinase Signaling Pathways in Magnaporthe oryzae.

    PubMed

    Li, Guotian; Zhang, Xue; Tian, Huan; Choi, Yoon-E; Andy Tao, W; Xu, Jin-Rong

    2017-02-28

    Appressorium formation plays a critical role in Magnaporthe oryzae. Mst50 is an adapter protein of the Mst11-Mst7-Pmk1 cascade that is essential for appressorium formation. To further characterize its functions, affinity purification was used to identify Mst50-interacting proteins (MIPs) in this study. Two of the MIPs are Mst11 and Mst7 that are known to interact with Mst50 for Pmk1 activation. Surprisingly, two other MIPs are Mck1 and Mkk2 that are the upstream kinases of the Mps1 pathway. Domain deletion analysis showed that the sterile alpha-motif of Mst50 but not the Ras-association domain was important for its interaction with Mck1 and responses to cell wall and oxidative stresses. The mst50 mutant was reduced in Mps1 activation under stress conditions. MIP11 encodes a RACK1 protein that also interacted with Mck1. Deletion of MIP11 resulted in defects in cell wall integrity, Mps1 phosphorylation, and plant infection. Furthermore, Mst50 interacted with histidine kinase Hik1, and the mst50 mutant was reduced in Osm1 phosphorylation. These results indicated that Mst50 is involved in all three MAPK pathways in M. oryzae although its functions differ in each pathway. Several MIPs are conserved hypothetical proteins and may be involved in responses to various signals and crosstalk among signaling pathways. This article is protected by copyright. All rights reserved.

  4. Mst1 inhibits CMECs autophagy and participates in the development of diabetic coronary microvascular dysfunction

    PubMed Central

    Lin, Jie; Zhang, Lei; Zhang, Mingming; Hu, Jianqiang; Wang, Tingting; Duan, Yu; Man, Wanrong; Wu, Bin; Feng, Jiaxu; Sun, Lei; Li, Congye; Zhang, Rongqing; Wang, Haichang; Sun, Dongdong

    2016-01-01

    Cardiovascular complications account for a substantial proportion of morbidity and mortality in diabetic patients. Abnormalities of cardiac microvascular endothelial cells (CMECs) lead to impaired cardiac microvascular vessel integrity and subsequent cardiac dysfunction, underlining the importance of coronary microvascular dysfunction. In this study, experimental diabetes models were constructed using Mst1 transgenic, Mst1 knockout and sirt1 knockout mice. Diabetic Mst1 transgenic mice exhibited impaired cardiac microvessel integrity and decreased cardiac function. Mst1 overexpression deceased CMECs autophagy as evidenced by decreased LC3 expression and enhanced protein aggregation when subjected to high glucose culture. Mst1 knockout improved cardiac microvessel integrity and enhanced cardiac functions in diabetic mice. Mst1 knockdown up-regulated autophagy as indicated by more typical autophagosomes and increased LC3 expression in CMECs subjected to high glucose cultures. Mst1 knockdown also promoted autophagic flux in the presence of bafilomycin A1. Mst1 overexpression increased CMECs apoptosis, whereas Mst1 knockout decreased CMECs apoptosis. Sirt1 knockout abolished the effects of Mst1 overexpression in cardiac microvascular injury and cardiac dysfunction. In conclusion, Mst1 knockout preserved cardiac microvessel integrity and improved cardiac functions in diabetic mice. Mst1 decreased sirt1 activity, inhibited autophagy and enhanced apoptosis in CMECs, thus participating in the pathogenesis of diabetic coronary microvascular dysfunction. PMID:27680548

  5. Effects of the concurrent use of a reduced dose of propofol with divided supplemental remifentanil and moderate hyperventilation on duration and morphology of electroconvulsive therapy-induced electroencephalographic seizure activity: A randomized controlled trial.

    PubMed

    Nishikawa, Kohki; Yamakage, Michiaki

    2017-02-01

    The clinical adequacy of electroconvulsive therapy (ECT) depends on not only seizure duration but also seizure amplitude and postictal suppression. The objective of this study was to evaluate the effects of combination of a reduced dose of propofol and moderate hyperventilation on seizure duration and electrical stimulus requirement for adequate ictal amplitude and postictal suppression. Prospective, randomized, controlled trial. Operating room at a municipal hospital. Sixty ASA physical status I or II patients scheduled to receive a total of >300 ECT treatments. Patients were randomly assigned to have the three interventions: the use of a standard dose (1mg/kg) of propofol and normoventilation (ETCO2 of 40-45mmHg) (group P/N), the use of a reduced dose (0.5mg/kg) of propofol with divided remifentanil injections and normoventilation (group RP/N), and the use of a reduced dose of propofol with divided remifentanil injections and moderate hyperventilation (ETCO2 of 30-35mmHg) (group RP/H). Patients in groups RP/N and RP/H received remifentanil 1μg/kg followed by propofol 0.5mg/kg for unconsciousness and thereafter remifentanil 1μg/kg immediately before the electrical stimulus. Patients in group RP/H had significantly longer durations of electroencephalographic (EEG) seizures in the early phase of the ECT course (P<0.05) and lower intensities of electrical stimulus in the late phase of the ECT course (P<0.05) than those in groups P/N and RP/N. A reduced dose of propofol combined with divided supplemental remifentanil under moderate hyperventilation during ECT may contribute to reduced electrical dosage due to the ability of its augmentation of seizure amplitude and postictal suppression in the late phase of the ECT course. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. 18. VIEW OF EAST SIDE INTERIOR OF MST AT STATIONS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. VIEW OF EAST SIDE INTERIOR OF MST AT STATIONS 3 AND 12, FACING WEST. COMPRESSED AIR TANK AND GENERATOR AT STATION 3. CURTAIN FOR NORTH ENVIRONMENTAL DOOR VISIBLE ON LEFT SIDE OF PHOTOGRAPH; RAIL VISIBLE AT BOTTOM OF PHOTOGRAPH. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  7. 15. BASE OF MST, SOUTHEAST SIDE, FACING SOUTHWEST. AIR COMPRESSOR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. BASE OF MST, SOUTHEAST SIDE, FACING SOUTHWEST. AIR COMPRESSOR SHED AT STATION 3; PLATFORM AT STATION 12; ENVIRONMENTAL CURTAIN SWING AT STATION 21. ELECTRICAL HOOKUPS ON RIGHT SIDE OF PHOTOGRAPH. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  8. 3. VIEW OF NORTHEAST CORNER OF MST. NOTE: ENVIRONMENTAL DOOR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. VIEW OF NORTHEAST CORNER OF MST. NOTE: ENVIRONMENTAL DOOR ON THE LOWER EAST SIDE OF THE NORTH FACE IS MISSING. NORTH CAMERA TOWER IN FOREGROUND. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  9. Overview of results from the MST reversed field pinch experiment

    NASA Astrophysics Data System (ADS)

    Sarff, J. S.; Almagri, A. F.; Anderson, J. K.; Borchardt, M.; Cappechi, W.; Carmody, D.; Caspary, K.; Chapman, B. E.; Den Hartog, D. J.; Duff, J.; Eilerman, S.; Falkowski, A.; Forest, C. B.; Galante, M.; Goetz, J. A.; Holly, D. J.; Koliner, J.; Kumar, S.; Lee, J. D.; Liu, D.; McCollam, K. J.; McGarry, M.; Mirnov, V. V.; Morton, L.; Munaretto, S.; Nornberg, M. D.; Nonn, P. D.; Oliva, S. P.; Parke, E.; Pueschel, M. J.; Reusch, J. A.; Sauppe, J.; Seltzman, A.; Sovinec, C. R.; Stone, D.; Theucks, D.; Thomas, M.; Triana, J.; Terry, P. W.; Waksman, J.; Whelan, G. C.; Brower, D. L.; Ding, W. X.; Lin, L.; Demers, D. R.; Fimognari, P.; Titus, J.; Auriemma, F.; Cappello, S.; Franz, P.; Innocente, P.; Lorenzini, R.; Martines, E.; Momo, B.; Piovesan, P.; Puiatti, M.; Spolaore, M.; Terranova, D.; Zanca, P.; Davydenko, V. I.; Deichuli, P.; Ivanov, A. A.; Polosatkin, S.; Stupishin, N. V.; Spong, D.; Craig, D.; Stephens, H.; Harvey, R. W.; Cianciosa, M.; Hanson, J. D.; Breizman, B. N.; Li, M.; Zheng, L. J.

    2015-10-01

    An overview of recent results from the MST reversed field pinch programme is presented. With neutral beam injection, bursty energetic particle (EP) modes are observed. The profiles of the magnetic and density fluctuations associated with these EP modes are measured using a far infrared interferometer-polarimeter. Equilibrium reconstructions of the quasi-single-helicity 3D helical state are provided by the V3FIT code that now incorporates several of MST's advanced diagnostics. The orientation of the helical structure is controlled using a new resonant magnetic perturbation technique. Gyrokinetic simulations based on experimental equilibria predict unstable trapped-electron modes (TEMs), and small-scale density fluctuations are detected in improved-confinement plasmas with TEM-like features. Upgraded pellet injection permits study of density and beta limits over MST's full range of operation, and an MST-record line-average density of 0.9 × 1020 m3 (n/nG = 1.4) has been obtained. Impurity ion temperature measurements reveal a charge-to-mass-ratio dependence in the rapid heating that occurs during a sawtooth crash. Runaway of NBI-born fast ions during the impulsive sawtooth event agrees with test-particle theory. Magnetic self-organization studies include measurements of the dynamo emf with an applied ac inductive electric field using oscillating field current drive.

  10. Overview of results from the MST reversed field pinch experiment

    NASA Astrophysics Data System (ADS)

    Sarff, J. S.; Almagri, A. F.; Anderson, J. K.; Borchardt, M.; Carmody, D.; Caspary, K.; Chapman, B. E.; Den Hartog, D. J.; Duff, J.; Eilerman, S.; Falkowski, A.; Forest, C. B.; Goetz, J. A.; Holly, D. J.; Kim, J.-H.; King, J.; Ko, J.; Koliner, J.; Kumar, S.; Lee, J. D.; Liu, D.; Magee, R.; McCollam, K. J.; McGarry, M.; Mirnov, V. V.; Nornberg, M. D.; Nonn, P. D.; Oliva, S. P.; Parke, E.; Reusch, J. A.; Sauppe, J. P.; Seltzman, A.; Sovinec, C. R.; Stephens, H.; Stone, D.; Theucks, D.; Thomas, M.; Triana, J.; Terry, P. W.; Waksman, J.; Bergerson, W. F.; Brower, D. L.; Ding, W. X.; Lin, L.; Demers, D. R.; Fimognari, P.; Titus, J.; Auriemma, F.; Cappello, S.; Franz, P.; Innocente, P.; Lorenzini, R.; Martines, E.; Momo, B.; Piovesan, P.; Puiatti, M.; Spolaore, M.; Terranova, D.; Zanca, P.; Belykh, V.; Davydenko, V. I.; Deichuli, P.; Ivanov, A. A.; Polosatkin, S.; Stupishin, N. V.; Spong, D.; Craig, D.; Harvey, R. W.; Cianciosa, M.; Hanson, J. D.

    2013-10-01

    An overview of recent results from the MST programme on physics important for the advancement of the reversed field pinch (RFP) as well as for improved understanding of toroidal magnetic confinement more generally is reported. Evidence for the classical confinement of ions in the RFP is provided by analysis of impurity ions and energetic ions created by 1 MW neutral beam injection (NBI). The first appearance of energetic-particle-driven modes by NBI in a RFP plasma is described. MST plasmas robustly access the quasi-single-helicity state that has commonalities to the stellarator and ‘snake’ formation in tokamaks. In MST the dominant mode grows to 8% of the axisymmetric field strength, while the remaining modes are reduced. Predictive capability for tearing mode behaviour has been improved through nonlinear, 3D, resistive magnetohydrodynamic computation using the measured resistivity profile and Lundquist number, which reproduces the sawtooth cycle dynamics. Experimental evidence and computational analysis indicates two-fluid effects, e.g., Hall physics and gyro-viscosity, are needed to understand the coupling of parallel momentum transport and current profile relaxation. Large Reynolds and Maxwell stresses, plus separately measured kinetic stress, indicate an intricate momentum balance and a possible origin for MST's intrinsic plasma rotation. Gyrokinetic analysis indicates that micro-tearing modes can be unstable at high beta, with a critical gradient for the electron temperature that is larger than for tokamak plasmas by roughly the aspect ratio.

  11. 41. VIEW OF DOOR FROM WEST ANTEROOM ON MST STATION ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    41. VIEW OF DOOR FROM WEST ANTEROOM ON MST STATION 111 INTO SERVICE AREA SHOWING SECURITY LOCK ON DOOR AND CONTROLS FOR WEST PLATFORMS IMMEDIATELY SOUTH (RIGHT) OF DOOR - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  12. 4. VIEW OF NORTH FACE OF MST. NOTE: ENVIRONMENTAL DOOR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. VIEW OF NORTH FACE OF MST. NOTE: ENVIRONMENTAL DOOR ON THE LOWER EAST SIDE OF THE NORTH FACE IS MISSING. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  13. 2. VIEW OF NORTHWEST CORNER OF MST. POWER LINES TO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. VIEW OF NORTHWEST CORNER OF MST. POWER LINES TO CAMERA TOWER IN FOREGROUND; UMBILICAL MAST ON RIGHT SIDE OF PHOTOGRAPH. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  14. Retrospective analysis of surgical treatment outcomes for gelastic seizures: a review of the literature.

    PubMed

    Likavec, A M; Dickerman, R D; Heiss, J D; Liow, K

    2000-04-01

    Gelastic seizures are known to be refractory to medical treatment and to date surgical therapy has yet to pinpoint the best treatment for these refractory seizures. There has been a multitude of case reports published on gelastic seizures and different surgical treatments, thus we performed a review of the literature on gelastic seizures and surgical treatments to elucidate the best surgical approaches for medically refractory gelastic seizures.

  15. Dreaming of seizures.

    PubMed

    Vercueil, Laurent

    2005-08-01

    Could some dreams and temporal lobe seizures share an intrinsic neuronal network? At the interplay of emotion, memory, dream, and temporal lobe seizure, we report on a patient with a left dysplastic amygdala and temporal lobe epilepsy who presented with a typical seizure while dreaming. Neuronal networks subserving affective states are suggested to be involved in emotional dream, memory recall, and amygdalo-hippocampal seizures.

  16. MO25 is a master regulator of SPAK/OSR1 and MST3/MST4/YSK1 protein kinases

    PubMed Central

    Filippi, Beatrice M; de los Heros, Paola; Mehellou, Youcef; Navratilova, Iva; Gourlay, Robert; Deak, Maria; Plater, Lorna; Toth, Rachel; Zeqiraj, Elton; Alessi, Dario R

    2011-01-01

    Mouse protein-25 (MO25) isoforms bind to the STRAD pseudokinase and stabilise it in a conformation that can activate the LKB1 tumour suppressor kinase. We demonstrate that by binding to several STE20 family kinases, MO25 has roles beyond controlling LKB1. These new MO25 targets are SPAK/OSR1 kinases, regulators of ion homeostasis and blood pressure, and MST3/MST4/YSK1, involved in controlling development and morphogenesis. Our analyses suggest that MO25α and MO25β associate with these STE20 kinases in a similar manner to STRAD. MO25 isoforms induce approximately 100-fold activation of SPAK/OSR1 dramatically enhancing their ability to phosphorylate the ion cotransporters NKCC1, NKCC2 and NCC, leading to the identification of several new phosphorylation sites. siRNA-mediated reduction of expression of MO25 isoforms in mammalian cells inhibited phosphorylation of endogenous NKCC1 at residues phosphorylated by SPAK/OSR1, which is rescued by re-expression of MO25α. MO25α/β binding to MST3/MST4/YSK1 also stimulated kinase activity three- to four-fold. MO25 has evolved as a key regulator of a group of STE20 kinases and may represent an ancestral mechanism of regulating conformation of pseudokinases and activating catalytically competent protein kinases. PMID:21423148

  17. Emerging targets for antidepressant therapies

    PubMed Central

    Rakofsky, Jeffrey J; Holtzheimer, Paul E; Nemeroff, Charles B

    2015-01-01

    Despite adequate antidepressant monotherapy, the majority of depressed patients do not achieve remission. Even optimal and aggressive therapy leads to a substantial number of patients who show minimal and often only transient improvement. In order to address this substantial problem of treatment-resistant depression, a number of novel targets for antidepressant therapy have emerged as a consequence of major advances in the neurobiology of depression. Three major approaches to uncover novel therapeutic interventions are: first, optimizing the modulation of monoaminergic neurotransmission; second, developing medications that act upon neurotransmitter systems other than monoaminergic circuits; and third, using focal brain stimulation to directly modulate neuronal activity. We review the most recent data on novel therapeutic compounds and their antidepressant potential. These include triple monoamine reuptake inhibitors, atypical antipsychotic augmentation, and dopamine receptor agonists. Compounds affecting extra-monoamine neurotransmitter systems include CRF1 receptor antagonists, glucocorticoid receptor antagonists, substance P receptor antagonists, NMDA receptor antagonists, nemifitide, omega-3 fatty acids, and melatonin receptor agonists. Focal brain stimulation therapies include vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS), magnetic seizure therapy (MST), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS). PMID:19501541

  18. Advances in Management of Neonatal Seizures

    PubMed Central

    Vesoulis, Zachary A.; Mathur, Amit M.

    2015-01-01

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

  19. MST1-dependent vesicle trafficking regulates neutrophil transmigration through the vascular basement membrane

    PubMed Central

    Kurz, Angela R.M.; Pruenster, Monika; Rohwedder, Ina; Ramadass, Mahalakshmi; Schäfer, Kerstin; Harrison, Ute; Nussbaum, Claudia; Immler, Roland; Wiessner, Johannes R.; Lim, Dae-Sik; Walzog, Barbara; Dietzel, Steffen; Moser, Markus; Klein, Christoph; Vestweber, Dietmar; Catz, Sergio D.

    2016-01-01

    Neutrophils need to penetrate the perivascular basement membrane for successful extravasation into inflamed tissue, but this process is incompletely understood. Recent findings have associated mammalian sterile 20–like kinase 1 (MST1) loss of function with a human primary immunodeficiency disorder, suggesting that MST1 may be involved in immune cell migration. Here, we have shown that MST1 is a critical regulator of neutrophil extravasation during inflammation. Mst1-deficient (Mst1–/–) neutrophils were unable to migrate into inflamed murine cremaster muscle venules, instead persisting between the endothelium and the basement membrane. Mst1–/– neutrophils also failed to extravasate from gastric submucosal vessels in a murine model of Helicobacter pylori infection. Mechanistically, we observed defective translocation of VLA-3, VLA-6, and neutrophil elastase from intracellular vesicles to the surface of Mst1–/– neutrophils, indicating that MST1 is required for this crucial step in neutrophil transmigration. Furthermore, we found that MST1 associates with the Rab27 effector protein synaptotagmin-like protein 1 (JFC1, encoded by Sytl1 in mice), but not Munc13-4, thereby regulating the trafficking of Rab27-positive vesicles to the cellular membrane. Together, these findings highlight a role for MST1 in vesicle trafficking and extravasation in neutrophils, providing an additional mechanistic explanation for the severe immune defect observed in patients with MST1 deficiency. PMID:27701149

  20. Involvement of Mst1 in tumor necrosis factor-{alpha}-induced apoptosis of endothelial cells

    SciTech Connect

    Ohtsubo, Hideki; Ichiki, Toshihiro Imayama, Ikuyo; Ono, Hiroki; Fukuyama, Kae; Hashiguchi, Yasuko; Sadoshima, Junichi; Sunagawa, Kenji

    2008-03-07

    Mammalian sterile 20-kinase 1 (Mst1), a member of the sterile-20 family protein kinase, plays an important role in the induction of apoptosis. However, little is know about the physiological activator of Mst1 and the role of Mst1 in endothelial cells (ECs). We examined whether Mst1 is involved in the tumor necrosis factor (TNF)-{alpha}-induced apoptosis of ECs. Western blot analysis revealed that TNF-{alpha} induced activation of caspase 3 and Mst1 in a time- and dose-dependent manner. TNF-{alpha}-induced Mst1 activation is almost completely prevented by pretreatment with Z-DEVD-FMK, a caspase 3 inhibitor. Nuclear staining with Hoechst 33258 and fluorescence-activated cell sorting of propidium iodide-stained cells showed that TNF-{alpha} induced apoptosis of EC. Diphenyleneiodonium, an inhibitor of NADPH oxidase, and N-acetylcysteine, a potent antioxidant, also inhibited TNF-{alpha}-induced activation of Mst1 and caspase 3, as well as apoptosis. Knockdown of Mst1 expression by short interfering RNA attenuated TNF-{alpha}-induced apoptosis but not cleavage of caspase 3. These results suggest that Mst1 plays an important role in the induction of TNF-{alpha}-induced apoptosis of EC. However, positive feedback mechanism between Mst1 and caspase 3, which was shown in the previous studies, was not observed. Inhibition of Mst1 function may be beneficial for maintaining the endothelial integrity and inhibition of atherogenesis.

  1. Bursts of seizures in long-term recordings of human focal epilepsy.

    PubMed

    Karoly, Philippa J; Nurse, Ewan S; Freestone, Dean R; Ung, Hoameng; Cook, Mark J; Boston, Ray

    2017-03-01

    We report on temporally clustered seizures detected from continuous long-term ambulatory human electroencephalographic data. The objective was to investigate short-term seizure clustering, which we have termed bursting, and consider implications for patient care, seizure prediction, and evaluating therapies. Chronic ambulatory intracranial electroencephalography (EEG) data collected for the purpose of seizure prediction were annotated to identify seizure events. A detection algorithm was used to identify bursts of events. Burst events were compared to nonburst events to evaluate event dispersion, duration and dynamics. Bursts of seizures were present in 6 of 15 subjects, and detections were consistent over long-term monitoring (>2 years). Subjects with bursts of seizures had highly overdispersed seizure rates, compared to other subjects. There was a complicated relationship between bursts and clinical seizures, although bursts were associated with multimodal distributions of seizure duration, and poorer predictive outcomes. For three subjects, bursts demonstrated distinctive preictal dynamics compared to clinical seizures. We have previously hypothesized that there are distinct physiologic pathways underlying short- and long-duration seizures. Herein we show that burst seizures fall almost exclusively within the short population of seizure durations; however, a short duration event was not sufficient to induce or imply bursting. We can therefore conclude that in addition to distinct mechanisms underlying seizure duration, there are separate factors regulating bursts of seizures. We show that bursts were a robust phenomenon in our patient cohort, which were consistent with overdispersed seizure rates, suggesting long-memory dynamics. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  2. [Psychogenic nonepileptic seizures: overview and implications for practice].

    PubMed

    Szita, Bernadett; Hidasi, Zoltán

    2016-05-15

    Psychogenic nonepileptic seizures are enigmatic disorders at the interface of neurology and psychiatry. Seizures resemble epileptic seizures but are not associated with electrical discharges in the brain. Symptoms typically start in early adulthood and women are far more affected than men. Video-EEG is widely considered to be the gold standard for diagnosis. Still psychogenic nonepileptic seizures are often misdiagnosed and treated as epilepsy for years that is burdensome to patients and costly to the healthcare system. Patients having psychogenic nonepileptic seizures show a high prevalence of traumatic life events, therefore, psychosocial factors are thought to play an important role in the etiology. Neurobiological factors may also contribute to the development of seizures as a subgroup of patients are characterized by cognitive impairment and subtle structural and functional brain abnormalities. Treatment includes psychotherapeutic procedures, particularly cognitive behavioral therapy and additional pharmacological interventions. This article presents an overview of the clinical context, diagnosis, etiology and treatment of psychogenic nonepileptic seizures.

  3. Efficacy and safety of extended-release oxcarbazepine (Oxtellar XR™) as adjunctive therapy in patients with refractory partial-onset seizures: a randomized controlled trial

    PubMed Central

    French, JA; Baroldi, P; Brittain, ST; Johnson, JK

    2014-01-01

    Objective To evaluate the efficacy, tolerability, and safety of once-daily 1200 mg and 2400 mg SPN-804 (Oxtellar XR™, Supernus Pharmaceuticals), an extended-release tablet formulation of oxcarbazepine (OXC), added to 1-3 concomitant antiepileptic drugs (AEDs) in adults with refractory partial-onset seizures, with or without secondary generalization. Methods The Prospective, Randomized Study of OXC XR in Subjects with Partial Epilepsy Refractory (PROSPER) study was a multinational, randomized, double-blind, parallel-group Phase 3 study. The primary efficacy endpoint was median percent reduction from baseline in monthly (28-day) seizure frequency for the 16-week double-blind treatment period in the intent-to-treat (ITT) population with analyzable seizure data. Other efficacy analyses included proportion of patients with ≥ 50% seizure reduction, proportion of patients seizure free, and the relationship between clinical response and plasma concentration. Results Median percent reduction was -28.7% for placebo, −38.2% (P = 0.08 vs placebo) for once-daily SPN-804 1200 mg, and −42.9% (P = 0.003) for SPN-804 2400 mg. Responder rates were 28.1%, 36.1% (P = 0.08), and 40.7% (P = 0.02); 16-week seizure-free rates in a pragmatic ITT analysis were 3.3%, 4.9% (P = 0.59), and 11.4% (P = 0.008), respectively. When data were analyzed separately for study site clusters, a post hoc analysis demonstrated that both SPN-804 dosages were significantly superior to placebo in median percent seizure reduction (placebo: −13.3%; 1200 mg: −34.5%, P = 0.02; 2400 mg: −52.7%, P = 0.006) in the North American study site cluster. A concentration–response analysis also supported a clinically meaningful effect for 1200 mg. Adverse event types reflected the drug's established profile. Adverse event frequency was consistent with a pharmacokinetic profile in which SPN-804 produces lower peak plasma concentrations vs immediate-release OXC. Once-daily dosing was not

  4. Hypermethylation of MST1 in IgG4-related autoimmune pancreatitis and rheumatoid arthritis

    SciTech Connect

    Fukuhara, Takataro; Tomiyama, Takashi; Yasuda, Kaneki; Ueda, Yoshihiro; Ozaki, Yoshio; Son, Yonsu; Nomura, Shosaku; Uchida, Kazushige; Okazaki, Kazuichi; Kinashi, Tatsuo

    2015-08-07

    The serine/threonine kinase Mst1 plays important roles in the control of immune cell trafficking, proliferation, and differentiation. Previously, we reported that Mst1 was required for thymocyte selection and regulatory T-cell functions, thereby the prevention of autoimmunity in mice. In humans, MST1 null mutations cause T-cell immunodeficiency and hypergammaglobulinemia with autoantibody production. RASSF5C(RAPL) is an activator of MST1 and it is frequently methylated in some tumors. Herein, we investigated methylation of the promoter regions of MST1 and RASSF5C(RAPL) in leukocytes from patients with IgG4-related autoimmune pancreatitis (AIP) and rheumatoid arthritis (RA). Increased number of CpG methylation in the 5′ region of MST1 was detected in AIP patients with extrapancreatic lesions, whereas AIP patients without extrapancreatic lesions were similar to controls. In RA patients, we detected a slight increased CpG methylation in MST1, although the overall number of methylation sites was lower than that of AIP patients with extrapancreatic lesions. There were no significant changes of the methylation levels of the CpG islands in the 5′ region of RASSF5C(RAPL) in leukocytes from AIP and RA patients. Consistently, we found a significantly down-regulated expression of MST1 in regulatory T cells of AIP patients. Our results suggest that the decreased expression of MST1 in regulatory T cells due to hypermethylation of the promoter contributes to the pathogenesis of IgG4-related AIP. - Highlights: • Mst1 controls immune cells trafficking, cell proliferation and differentiation. • Autoimmune pancreatitis (AIP) is an idiopathic pancreatitis affecting multiple organs. • Decreased MST1 expression and increased CpG methylation of promoter of MST1 in AIP. • Slight increased CpG methylation of MST1 in rheumatoid arthritis patients. • MST1 contributes pathogenesis of IgG4-related AIP.

  5. Overexpression of MYC and EZH2 cooperates to epigenetically silence MST1 expression

    PubMed Central

    Kuser-Abali, Gamze; Alptekin, Ahmet; Cinar, Bekir

    2014-01-01

    Hippo-like MST1 protein kinase regulates cell growth, organ size, and carcinogenesis. Reduction or loss of MST1 expression is implicated in poor cancer prognosis. However, the mechanism leading to MST1 silencing remains elusive. Here, we report that both MYC and EZH2 function as potent suppressors of MST1 expression in human prostate cancer cells. We demonstrated that concurrent overexpression of MYC and EZH2 correlated with the reduction or loss of MST1 expression, as shown by RT-qPCR and immunoblotting. Methylation sensitive PCR and bisulfite genomic DNA sequencing showed that DNA methylation caused MST1 silencing. Pharmacologic and RNAi experiments revealed that MYC and EZH2 silenced MST1 expression by inhibiting its promoter activity, and that EZH2 was a mediator of the MYC-induced silencing of MST1. In addition, MYC contributed to MST1 silencing by partly inhibiting the expression of microRNA-26a/b, a negative regulator of EZH2. As shown by ChIP assays, EZH2-induced DNA methylation and H3K27me3 modification, which was accompanied by a reduced H3K4me3 mark and RNA polymerase II occupancy on the MST1 promoter CpG region, were the underlying cause of MST1 silencing. Moreover, potent pharmacologic inhibitors of MYC or EZH2 suppressed prostate cancer cell growth in vitro, and the knockdown of MST1 caused cells’ resistance to MYC and EZH2 inhibitor-induced growth retardation. These findings indicate that MYC, in concert with EZH2, epigenetically attenuates MST1 expression and suggest that the loss of MST1/Hippo functions is critical for the MYC or EZH2 mediation of cancer cell survival. PMID:24499724

  6. Multisystemic Therapy for Externalizing Youth

    PubMed Central

    Zajac, Kristyn; Randall, Jeff; Swenson, Cynthia Cupit

    2015-01-01

    Synopsis Externalizing problems are multi-determined and related to individual, family, peer, school, and community risk factors. Multisystemic therapy (MST) was originally developed to address these risk factors among youth with serious conduct problems who were at-risk for out-of-home placement. Several decades of research has established MST as an evidence-based intervention for adolescents with serious clinical problems, including serious offending, delinquency, substance abuse, and parental physical abuse and neglect. Further, research points to the importance of maintaining high treatment fidelity through systematic quality assurance procedures to replicate positive clinical outcomes. This paper presents an overview of the clinical procedures and evidence base of MST for externalizing problems as well as two adaptations: MST for Substance Abuse and MST for Child Abuse and Neglect. PMID:26092742

  7. Athletes with seizure disorders.

    PubMed

    Knowles, Byron Don; Pleacher, Michael D

    2012-01-01

    Individuals with seizure disorders have long been restricted from participation in certain sporting activities. Those with seizure disorders are more likely than their peers to have a sedentary lifestyle and to develop obesity. Regular participation in physical activity can improve both physical and psychosocial outcomes for persons with seizure disorders. Seizure activity often is reduced among those patients who regularly engage in aerobic activity. Recent literature indicates that the diagnosis of seizure disorders remains highly stigmatizing in the adolescent population. Persons with seizure disorders may be more accepted by peer groups if they are allowed to participate in sports and recreational activities. Persons with seizure disorders are encouraged to participate in regular aerobic activities. They may participate in team sports and contact or collision activities provided that they utilize appropriate protective equipment. There seems to be no increased risk of injury or increasing seizure activity as the result of such participation. Persons with seizure disorders still are discouraged from participating in scuba diving and skydiving. The benefits of participation in regular sporting activity far outweigh any risk to the athlete with a seizure disorder who chooses to participate in sports.

  8. Focal nonconvulsive seizures during detoxification for benzodiazepine abuse.

    PubMed

    Albiero, Anna; Brigo, Francesco; Faccini, Marco; Casari, Rebecca; Quaglio, Gianluca; Storti, Monica; Fiaschi, Antonio; Bongiovanni, Luigi Giuseppe; Lugoboni, Fabio

    2012-02-01

    Chronic benzodiazepine (BDZ) abuse is currently treated with detoxification using a low-dose flumazenil infusion, a relatively recently developed and promising procedure. Given the possibility reported in the literature of the occurrence of generalized seizures during therapeutic BDZ detoxification, we usually administer preventive antiepileptic drug (AED) therapy. We describe two patients with no previous history of seizures or evidence of intracerebral lesions who, during detoxification for benzodiazepine abuse, developed repetitive focal nonconvulsive seizures instead of generalized seizures, even with appropriate doses of preventive AED therapy. There are no previous reported cases of focal nonconvulsive seizures occurring during this procedure or, more generally, during abrupt BDZ discontinuation. The cases we describe suggest that during detoxification for BDZ abuse, not only generalized, but also focal nonconvulsive seizures may occur. In this context, the focal seizures probably result from a diffuse decrease in the seizure threshold (caused by a generalized excitatory rebound), which may trigger focal seizures arising from cortical regions with higher intrinsic epileptogenicity. Detoxification for benzodiazepine abuse, even if performed with adequate-dosage AED treatment, may not be as safe a procedure as previously considered, because not only convulsive, but also nonconvulsive seizures may occur and go unnoticed. It is therefore strongly advisable to perform this detoxification under close medical supervision and to maintain a low threshold for EEG monitoring in the event of sudden onset of behavioral changes. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Seizure from hyponatremia in infants. Early recognition and treatment.

    PubMed

    Sharf, R E

    1993-06-01

    To determine whether history, vital signs, and physical examination may be used as predictors of hyponatremia in first-time seizure in infancy; to examine the efficacy and safety of 3% saline bolus administered to control seizures; and to determine whether early intervention reduces apnea-related complications. Retrospective case series comparing clinical characteristics and initial laboratory data of infants with hyponatremic seizures and seizures of other categories. Treatment strategies and outcomes are examined in hyponatremic infants to determine the efficacy and safety of 3% saline administration. Tertiary care community medical center. Fifty-six consecutive infants under 1 year of age with first-time seizure. Fifteen infants (27%) had hyponatremic seizure. They were younger and had lower body temperatures, higher serum glucose concentrations, and lower serum bicarbonate concentrations than infants with nonhyponatremic seizure (P < .05). All infants with hyponatremic seizure were formula fed; 13 (87%) had excessive solute-poor fluid. Hyponatremic seizures were more difficult to control and required more frequent intubation. Three of seven hyponatremic infants treated early with 3% saline required intubation. Six of eight infants who received delayed 3% saline solution or none required intubation. No adverse effects resulted from administration of hypertonic saline. Parameters for recognizing hyponatremic seizure include age less than 6 months; formula with solute-poor fluid; absence of significant medical history or recent febrile illness, hypothermia, hyperglycemia, status epilepticus, and absence of evidence of trauma. Bolus 3% saline was safe and effective in controlling hyponatremic seizure; early use reduced morbidity from anticonvulsant therapy.

  10. Studying Filamentary Currents with Thomson Scattering on MST

    NASA Astrophysics Data System (ADS)

    den Hartog, D. J.; Young, W. C.; Kubala, S. Z.

    2016-10-01

    The MST reversed-field pinch plasma generates bursts of toroidally localized magnetic activity associated with m = 0 modes resonant at the reversal surface near the plasma edge. Previously, using data from an array of edge magnetic probes, these bursts were connected to poloidal current filaments. Now the MST Thomson scattering diagnostic is being used to measure the net drift in the electron distribution due to these currents. An additional long-wavelength spectral bin has been added to several Thomson scattering polychromators, in addition to 5-7 pre-existing short wavelength spectral bins, to improve discrimination between shifted vs. broadened spectra. The bursts are examined in plasma conditions that display spontaneous periods of low tearing-mode activity, with higher confinement and higher temperatures that improve Thomson scattering measurement performance. This work is supported by the U.S. Department of Energy and the National Science Foundation.

  11. Criteria and algorithms for spectrum parameterization of MST radar signals

    NASA Technical Reports Server (NTRS)

    Rastogi, P. K.

    1984-01-01

    The power spectra S(f) of MST radar signals contain useful information about the variance of refractivity fluctuations, the mean radial velocity, and the radial velocity variance in the atmosphere. When noise and other contaminating signals are absent, these quantities can be obtained directly from the zeroth, first and second order moments of the spectra. A step-by-step procedure is outlined that can be used effectively to reduce large amounts of MST radar data-averaged periodograms measured in range and time to a parameterized form. The parameters to which a periodogram can be reduced are outlined and the steps in the procedure, that may be followed selectively, to arrive at the final set of reduced parameters are given. Examples of the performance of the procedure are given and its use with other radars are commented on.

  12. Recent Ion Energy Distribution Observations on MST RFP Plasmas

    NASA Astrophysics Data System (ADS)

    Clark, Jerry; Titus, J. B.; Mezonlin, E. D.; Johnson, J. A., III; Almagri, A. F.; Andeson, J. A.

    2015-11-01

    Ion energy distribution and temperature measurements have been made on the Madison Symmetric Torus (MST) using the Florida A&M University compact neutral particle analyzer (CNPA). The CNPA is a low energy (0.34-5.2 keV), high energy resolution (25 channels) neutral particle analyzer, with a radial view on MST. Recently, a retarding potential system was built to allow CNPA measurements to ensemble a complete ion energy distribution with high-energy resolution, providing insight into the dynamics of the bulk and fast ion populations. Recent work has also been done to improve the analysis techniques used to infer the ion temperature measurements, allowing us to understand temperature dynamics better during global magnetic reconnection events. Work supported in part by grants to FAMU and to UW from NSF and from Fusion Energy Sciences at DOE.

  13. A Role for MST Neurons in Heading Estimation

    NASA Technical Reports Server (NTRS)

    Stone, L. S.; Perrone, J. A.

    1994-01-01

    A template model of human visual self-motion perception, which uses neurophysiologically realistic "heading detectors", is consistent with numerous human psychophysical results including the failure of humans to estimate their heading (direction of forward translation) accurately under certain visual conditions. We tested the model detectors with stimuli used by others in single-unit studies. The detectors showed emergent properties similar to those of MST neurons: (1) Sensitivity to non-preferred flow; Each detector is tuned to a specific combination of flow components and its response is systematically reduced by the addition of nonpreferred flow, and (2) Position invariance; The detectors maintain their apparent preference for particular flow components over large regions of their receptive fields. It has been argued that this latter property is incompatible with MST playing a role in heading perception. The model however demonstrates how neurons with the above response properties could still support accurate heading estimation within extrastriate cortical maps.

  14. Ganaxolone: A New Treatment for Neonatal Seizures

    PubMed Central

    Yawno, Tamara; Miller, Suzie L.; Bennet, Laura; Wong, Flora; Hirst, Jonathan J.; Fahey, Michael; Walker, David W.

    2017-01-01

    Neonatal seizures are amongst the most common neurologic conditions managed by a neonatal care service. Seizures can exacerbate existing brain injury, induce “de novo” injury, and are associated with neurodevelopmental disabilities in post-neonatal life. In this mini-review, we present evidence in support of the use of ganaxolone, a GABAA agonist neurosteroid, as a novel neonatal therapy. We discuss evidence that ganaxolone can provide both seizure control and neuroprotection with a high safety profile when administered early following birth-related hypoxia, and show evidence that it is likely to prevent or reduce the incidence of the enduring disabilities associated with preterm birth, cerebral palsy, and epilepsy. We suggest that ganaxolone is an ideal anti-seizure treatment because it can be safely used prospectively, with minimal or no adverse effects on the neonatal brain. PMID:28878622

  15. Effect of age and anticonvulsants on seizure threshold during bilateral electroconvulsive therapy with brief-pulse stimulus: A chart-based analysis

    PubMed Central

    Nitturkar, Abhishek R.; Sinha, Preeti; Bagewadi, Virupakshappa I.; Thirthalli, Jagadisha

    2016-01-01

    Background: Efficacy and adverse effects of electroconvulsive therapy (ECT) depend on the extent to which the electrical stimulus exceeds patients' seizure thresholds (STs). Titration method of estimating ST is recommended. Age and co-prescribed anticonvulsants (ACs) are known to affect ST. Literature on ST in bilateral ECT (BLECT) is sparse. Objective: To explore the clinical and demographic determinants of ST in a clinically representative sample of patients prescribed with BLECT. Materials and Methods: ECT records of 640 patients who received BLECT in 2011 in an academic psychiatric setting were studied. Demographic, clinical, pharmacological, and ECT details were analyzed. As per the standard practice, during the 1st ECT session, ST was determined by titration method, starting with 30 milli-Coulombs (mC) and increasing by 30 mC and thence in steps of 60 mC. Increase in ST over up to 6th session of ECT was noted. Receiver operating characteristic curve was used to find age cut-off with high specificity for ST ≥120 mC. The associations of ST and increase in ST with the age cut-off and other clinical factors were assessed using Chi-square test and logistic regression analysis. Results: The mean age was 30.98 years (+11.23 years) and mean ST at 1st ECT session was 130.36 mC (+51.96 mC). There was significantly high positive correlation (r = 0.37, P < 0.001) between age and ST. Cut-off age of 45 years had high specificity: Only 4.6% of those older than 45 years had ST <120 mC. Higher proportion of patients on AC had ST ≥120 mC. These associations were seen even after controlling for potential confounds of each other using logistic regression analysis. The results were similar for increase in ST over the course of ECT. Sex, diagnosis, use of antipsychotics, antidepressants, lithium, and benzodiazepines (BZPs) had no effect on ST or its increase. Conclusions: For BLECT using brief-pulse stimulus, ST depends on age and use of AC. For patients above the age of 45

  16. Reduction of pentylenetetrazole-induced seizure activity in awake rats by seizure-triggered trigeminal nerve stimulation.

    PubMed

    Fanselow, E E; Reid, A P; Nicolelis, M A

    2000-11-01

    Stimulation of the vagus nerve has become an effective method for desynchronizing the highly coherent neural activity typically associated with epileptic seizures. This technique has been used in several animal models of seizures as well as in humans suffering from epilepsy. However, application of this technique has been limited to unilateral stimulation of the vagus nerve, typically delivered according to a fixed duty cycle, independently of whether ongoing seizure activity is present. Here, we report that stimulation of another cranial nerve, the trigeminal nerve, can also cause cortical and thalamic desynchronization, resulting in a reduction of seizure activity in awake rats. Furthermore, we demonstrate that providing this stimulation only when seizure activity begins results in more effective and safer seizure reduction per second of stimulation than with previous methods. Seizure activity induced by intraperitoneal injection of pentylenetetrazole was recorded from microwire electrodes in the thalamus and cortex of awake rats while the infraorbital branch of the trigeminal nerve was stimulated via a chronically implanted nerve cuff electrode. Continuous unilateral stimulation of the trigeminal nerve reduced electrographic seizure activity by up to 78%, and bilateral trigeminal stimulation was even more effective. Using a device that automatically detects seizure activity in real time on the basis of multichannel field potential signals, we demonstrated that seizure-triggered stimulation was more effective than the stimulation protocol involving a fixed duty cycle, in terms of the percent seizure reduction per second of stimulation. In contrast to vagus nerve stimulation studies, no substantial cardiovascular side effects were observed by unilateral or bilateral stimulation of the trigeminal nerve. These findings suggest that trigeminal nerve stimulation is safe in awake rats and should be evaluated as a therapy for human seizures. Furthermore, the results

  17. Comparison of Beijing MST radar and radiosonde horizontal wind measurements

    NASA Astrophysics Data System (ADS)

    Tian, Yufang; Lü, Daren

    2017-01-01

    To determine the performance and data accuracy of the 50 MHz Beijing Mesosphere-Stratosphere-Troposphere (MST) radar, comparisons of radar measured horizontal winds in the height range 3-25 km with radiosonde observations were made during 2012. A total of 427 profiles and 15 210 data pairs were compared. There was very good agreement between the two types of measurement. Standard deviations of difference (mean difference) for wind direction, wind speed, zonal wind and meridional wind were 24.86° (0.77°), 3.37 (-0.44), 3.33 (-0.32) and 3.58 (-0.25) m s-1, respectively. The annual standard deviations of differences for wind speed were within 2.5-3 m s-1 at all heights apart from 10-15 km, the area of strong winds, where the values were 3-4 m s-1. The relatively larger differences were mainly due to wind field variations in height regions with larger wind speeds, stronger wind shear and the quasi-zero wind layer. A lower MST radar SNR and a lower percentage of data pairs compared will also result in larger inconsistencies. Importantly, this study found that differences between the MST radar and radiosonde observations did not simply increase when balloon drift resulted in an increase in the real-time distance between the two instruments, but also depended on spatiotemporal structures and their respective positions in the contemporary synoptic systems. In this sense, the MST radar was shown to be a unique observation facility for atmospheric dynamics studies, as well as an operational meteorological observation system with a high temporal and vertical resolution.

  18. Plasma physics research in the MST toroidal confinement device

    SciTech Connect

    Not Available

    1991-01-01

    MST has matured in its operation to the point that substantial physics results are emerging. This paper contains accomplishments in FY 91 separated into physics results, diagnostic improvements, and machine improvements. In addition to achievements of the eight months which covers 11/1/91 to the present (7/15/91), we include the expected progress in the remaining four months of the grant period.

  19. Signal processing at the Poker Flat MST radar

    NASA Technical Reports Server (NTRS)

    Carter, D. A.

    1983-01-01

    Signal processing for Mesosphere-Stratosphere-Troposphere (MST) radar is carried out by a combination of hardware in high-speed, special-purpose devices and software in a general-purpose, minicomputer/array processor. A block diagram of the signal processing system is presented, and the steps in the processing pathway are described. The current processing capabilities are given, and a system offering greater coherent integration speed is advanced which hinges upon a high speed preprocessor.

  20. 38. STATION 124 OF MST, NORTH SIDE. FEATURES LEFT TO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    38. STATION 124 OF MST, NORTH SIDE. FEATURES LEFT TO RIGHT: COMMUNICATIONS PANEL, CONTROL REEL (120 VOLTS), HYDRAULIC POWER UNIT, DOOR CONTROLS (480 VOLTS), POWER REEL (480 VOLTS), CRANE NORTH/CRANE SOUTH DOORS (480 VOLTS), CIRCUIT BREAKER FOR TEN-TON BRIDGE CRANE, DUCT HEATER 122. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  1. Focal seizure symptoms in idiopathic generalized epilepsies.

    PubMed

    Seneviratne, Udaya; Woo, Jia J; Boston, Ray C; Cook, Mark; D'Souza, Wendyl

    2015-08-18

    We sought to study the frequency and prognostic value of focal seizure symptoms (FSS) in idiopathic generalized epilepsies (IGE) using a validated tool: Epilepsy Diagnostic Interview Questionnaire and Partial Seizure Symptom Definitions. Participants with IGE were recruited from epilepsy clinics at 2 tertiary hospitals. The diagnosis was validated and classified into syndromes according to the International League Against Epilepsy criteria by 2 epileptologists independently with discordance resolved by consensus. The Epilepsy Diagnostic Interview Questionnaire utilizes both open- and closed-ended questions to elicit FSS in association with generalized tonic-clonic seizures, myoclonus, and absences. The elicited FSS were classified according to the Partial Seizure Symptom Definitions. Regression analysis was conducted to examine the relationship between the duration of seizure freedom and FSS. A total of 135 patients were studied, of whom 70 (51.9%) reported FSS. Those symptoms occurred in association with generalized tonic-clonic seizures (53.1%) as well as myoclonus and absences (58%). FSS were reported with similar frequency in juvenile absence epilepsy (62.5%) and juvenile myoclonic epilepsy (60%), and with a lesser frequency in generalized epilepsy with tonic-clonic seizures only (39.5%) and childhood absence epilepsy (33.3%). A strong relationship between FSS and duration of seizure freedom was found (regression coefficient -0.665, p = 0.037). FSS are frequently reported by patients with IGE. A shorter duration of seizure freedom is associated with FSS. Recognition of the presence of FSS in IGE is important to avoid misdiagnosis and delayed diagnosis as well as to choose appropriate antiepileptic drug therapy. © 2015 American Academy of Neurology.

  2. Physics and optimization of plasma startup in the MST RFP

    NASA Astrophysics Data System (ADS)

    Mao, W.; Chapman, B. E.; Almagri, A. F.; Anderson, J. K.; den Hartog, D. J.; Ko, J.; Kumar, S. T. A.; Morton, L.; Parke, E.; Reusch, J. A.; Waksman, J.; Brower, D. L.; Ding, W. X.; Lin, L.

    2012-10-01

    MST's Bp circuit relies on an iron core transformer, and the 2 V-s flux swing of the iron sets limits on the peak Ip and discharge duration. A substantial fraction of this flux is consumed during startup of each discharge. To some extent, this flux consumption can be reduced by applying a larger vacuum Bt at discharge initiation, a fact long known in RFP research. However, the detailed physics of this Bt dependence is not completely understood. Toward better understanding, MST's profile diagnostics are being employed to try to measure the temporal evolution of, e.g., the magnetic equilibrium and plasma resistance. Initial target plasmas have a peak Ip of about 600 kA but with different vacuum Bt. Initial results include the observation of m = 1 modes, with n = 1, 2, 3... growing and decaying in succession. This occurs as the Bt profile evolves rapidly from that of a tokamak to that of an RFP. Preliminary reconstructions of the toroidal current profile suggest that it is initially quite hollow. This work should help optimize startup with MST's new Bt programmable power supply.

  3. Simulation of MST tokamak discharges with resonant magnetic perturbations

    NASA Astrophysics Data System (ADS)

    Cornille, B. S.; Sovinec, C. R.; Chapman, B. E.; Dubois, A.; McCollam, K. J.; Munaretto, S.

    2016-10-01

    Nonlinear MHD modeling of MST tokamak plasmas with an applied resonant magnetic perturbation (RMP) reveals degradation of flux surfaces that may account for the experimentally observed suppression of runaway electrons with the RMP. Runaway electrons are routinely generated in MST tokamak discharges with low plasma density. When an m = 3 RMP is applied these electrons are strongly suppressed, while an m = 1 RMP of comparable amplitude has little effect. The computations are performed using the NIMROD code and use reconstructed equilibrium states of MST tokamak plasmas with q (0) < 1 and q (a) = 2.2 . Linear computations show that the (1 , 1) -kink and (2 , 2) -tearing modes are unstable, and nonlinear simulations produce sawtoothing with a period of approximately 0.5 ms, which is comparable to the period of MHD activity observed experimentally. Adding an m = 3 RMP in the computation degrades flux surfaces in the outer region of the plasma, while no degradation occurs with an m = 1 RMP. The outer flux surface degradation with the m = 3 RMP, combined with the sawtooth-induced distortion of flux surfaces in the core, may account for the observed suppression of runaway electrons. Work supported by DOE Grant DE-FC02-08ER54975.

  4. MST1 activation by curcumin mediates JNK activation, Foxo3a nuclear translocation and apoptosis in melanoma cells

    SciTech Connect

    Yu, Teng; Ji, Jiang; Guo, Yong-li

    2013-11-08

    Highlights: •Curcumin activates MST1 in melanoma cells. •MST1 mediates curcumin-induced apoptosis of melanoma cells. •ROS production is involved in curcumin-induced MST1 activation. •MST1 mediates curcumin-induced JNK activation in melanoma cells. •MST1 mediates curcumin-induced Foxo3a nuclear translocation and Bim expression. -- Abstract: Different groups including ours have shown that curcumin induces melanoma cell apoptosis, here we focused the role of mammalian Sterile 20-like kinase 1 (MST1) in it. We observed that curcumin activated MST1-dependent apoptosis in cultured melanoma cells. MST1 silencing by RNA interference (RNAi) suppressed curcumin-induced cell apoptosis, while MST1 over-expressing increased curcumin sensitivity. Meanwhile, curcumin induced reactive oxygen species (ROS) production in melanoma cells, and the ROS scavenger, N-acetyl-cysteine (NAC), almost blocked MST1 activation to suggest that ROS might be required for MST1 activation by curcumin. c-Jun N-terminal protein kinase (JNK) activation by curcumin was dependent on MST1, since MST1 inhibition by RNAi or NAC largely inhibited curcumin-induced JNK activation. Further, curcumin induced Foxo3 nuclear translocation and Bim-1 (Foxo3 target gene) expression in melanoma cells, such an effect by curcumin was inhibited by MST1 RNAi. In conclusion, we suggested that MST1 activation by curcumin mediates JNK activation, Foxo3a nuclear translocation and apoptosis in melanoma cells.

  5. Seizure semiology and aging.

    PubMed

    Silveira, Diosely C; Jehi, Lara; Chapin, Jessica; Krishnaiengar, Suparna; Novak, Eric; Foldvary-Schaefer, Nancy; Najm, Imad

    2011-02-01

    The incidence of epilepsy is high in older individuals. However, epilepsy in the elderly may be underdiagnosed and undertreated because of diagnostic difficulties. The main goal of this study was to determine whether seizure semiology differs between older and younger adults with epilepsy in the outpatient setting. Fifty patients with focal epilepsy aged 55 years and older and 50 patients aged between 18 and 45 years were included. Review of medical records contained detailed seizure description. There were no differences in seizure semiology between groups, except that subtle perceptions of transient confusion were seen in older patients but not in younger patients (P=0.0028). Older patients had less generalized motor seizures, but the differences between groups did not reach significance (P=0.01). Older patients may present with subtle symptoms of seizures characterized by brief periods of confusion, which may contribute to greater difficulty diagnosing seizures in the elderly. Copyright © 2010 Elsevier Inc. All rights reserved.

  6. Value and limitations of seizure semiology in localizing seizure onset.

    PubMed

    So, Elson L

    2006-08-01

    Seizure semiology has been the foundation of clinical diagnosis of seizure disorders. This article discusses the value and the limitations of behavioral features of seizure episodes in localizing seizure onset. Studies have shown that some semiologic features of seizures are highly accurate in the hemispheric lateralization and lobar localization of seizures. There is good agreement between blinded reviewers in lateralizing video-recorded seizures in temporal lobe and extratemporal lobe epilepsies. However, seizure semiology alone should not be used to determine the site of seizure onset. Each semiologic feature may falsely localize seizure onset. Seizure semiology in some patients may signify the site of seizure propagation rather than origination. Moreover, seizure semiology may not be as reliable in multifocal epilepsies as it is in unifocal epilepsies. Many semiologic features of seizures of adults are often missing in seizures of children. Seizure semiology should be analyzed and integrated with EEG and neuroimaging data to localize the seizure focus. A sample of the recorded seizures should be shown to the patient's relatives or friends to verify that it is representative of habitual seizures.

  7. Quality of life, mood and seizure control in patients with brain tumor related epilepsy treated with lacosamide as add-on therapy: A prospective explorative study with a historical control group.

    PubMed

    Maschio, Marta; Zarabla, Alessia; Maialetti, Andrea; Fabi, Alessandra; Vidiri, Antonello; Villani, Veronica; Giannarelli, Diana

    2017-08-01

    Brain tumor-related epilepsy (BTRE) is often drug resistant and patients can be forced to take polytherapy that can adversely affect their quality of life (QoL). Lacosamide (LCM) is a new antiepileptic drug (AED) used as adjunctive therapy in patients with partial seizures with or without secondary generalization, with a favorable pharmacokinetic profile that seems to be effective and well tolerated. Therefore it represents a possible therapeutic choice for patients with BTRE. We propose a prospective study with a historical control group to evaluate the effect of LCM as add-on therapy on seizure control and quality of life in patients with BTRE. This study has been designed to test the superiority of Lacosamide over Levetiracetam as an add-on. We compared a prospective cohort of 25 patients treated with Lacosamide with a historical control group (n=19) treated with Levetiracetam as an add-on. We recruited 25 adult patients (M 18, F 7; mean age 41.9) affected by BTRE with uncontrolled partial-onset seizures treated with AED polytherapy. We added LCM as an add-on. Patients were evaluated at baseline, after 3months and at 6months. This population has been compared with a historical control group of 19 BTRE adult patients (M 13, F 6; median age 48.0, range: 28-70) with uncontrolled partial-onset seizures treated with LEV as add-on. The patients underwent QoL, mood and adverse events tests (Adverse Event Profile-AEP) and evaluation of seizure frequency. Twelve patients had high grade gliomas, and thirteen had low grade gliomas. During follow-up, thirteen patients underwent chemotherapy, three radiotherapy and five patients had disease progression. Nine patients had simple partial seizures, eight had complex partial seizures, and eight had secondary generalized seizures. Fifteen patients were in monotherapy and ten in polytherapy with AEDs. LCM was added up to reach the maximum dosage of 400mg/die (mean final dose 300mg/die). Four patients dropped out due to poor

  8. Mst-1 deficiency promotes post-traumatic spinal motor neuron survival via enhancement of autophagy flux.

    PubMed

    Zhang, Mengting; Tao, Wufan; Yuan, Zengqiang; Liu, Yaobo

    2017-08-21

    The mammalian Ste20-like kinase 1 (Mst-1) is a serine-threonine kinase and a component of the Hippo tumor suppressor pathway, which reacts to pathologically relevant stress and regulates cell death. However, little is known about its role in spinal cord injury (SCI). Here, we found that p-Mst-1, the activated form of Mst-1, was induced in the post-traumatic spinal motor neurons. In vivo evidence demonstrated that Mst-1 deficiency promoted post-traumatic spinal motor neuron survival, BMS scores, and synapse survival. Moreover, we found autophagosome formation and autolysosome degradation enhanced by Mst-1 deficiency were crucial to attenuate the death of injured spinal motor neurons. Taken together, our findings demonstrate that Mst-1 deficiency promotes post-traumatic spinal motor neuron survival via enhancement of autophagy flux. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. [Seizures in neurofibromatosis. What is the risk?].

    PubMed

    Drouet, A

    2011-12-01

    The prevalence and the type of seizures associated with neurofibromatosis 1 (NF1) and 2 (NF2) are not adequately characterized. NF1 has a birth incidence of one in 2500, and NF2 one in 25000. Seizures are an occasional complication in NF1 patients and there is no data for NF2 patients. Central nervous system tumors are always suspected, since NF1 and NF2 are caused by mutations in tumor suppressor gene controlling cell proliferation and differentiation. The aim of this article is to provide a synthetic overview about epilepsy associated with NF1 and NF2 based on published studies. In NF1, the type of seizures and their response to therapy are reported, the heterogeneity of etiology is also discussed. For NF2 patients, no specific data are available; the current knowledge comes from series of NF2 patients for which seizures has revealed the disease or from isolated case reports of tumors associated with seizures. Cryptogenic epilepsy without anatomic defect is likely to be related to NF1, while seizures seem to be secondary to leptomeningeal tumors (meningioma, meningioangiomatosis) in NF2 patients. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  10. Intranasal midazolam for seizure cessation in the community setting

    PubMed Central

    Zelcer, Michal; Goldman, Ran D.

    2016-01-01

    Question There are times when parents arrive to my clinic after their child has had a seizure and a second seizure takes place in the clinic. While waiting for transport to the hospital, are there ways to stop the seizures without the need to obtain intravenous access in the clinic? Answer Intravenous diazepam has been a first-line therapy to stop seizures in children for many years. Other routes of drug administration such as intramuscular, rectal, and buccal are available but have several limitations. More evidence suggests that the intranasal route to administer drugs is quick and effective in children, and the use of midazolam has been continuing to show promise in seizure cessation. With its good safety profile, intranasal midazolam can be used in the clinic and prehospital setting for seizure cessation in children. PMID:27412207

  11. Seizures Related to Hypomagnesemia

    PubMed Central

    Chen, Becky Biqi; Prasad, Chitra; Kobrzynski, Marta; Campbell, Craig

    2016-01-01

    Objective: Childhood seizures have various nonneurological etiologies. The patient’s magnesium levels should be measured when evaluating afebrile seizures. The purpose of the current case series is to describe a systematic approach for diagnosing hypomagnesemia using 3 recent patient cases. Methods: This case series describes 3 patients with unprovoked hypomagnesemia-associated seizures. The authors describe the differential diagnosis, pathophysiology, and the workup of hypomagnesemia-associated seizures. Results: Hypomagnesemia contributed to the cause of the seizures in all 3 cases. Various causes of hypomagnesemia were investigated, including genetic etiologies. All 3 patients were maintained at a magnesium level >0.65 mmol/L, which improved or eliminated the seizures. Significance: Magnesium levels should always be measured when trying to determine the etiology of seizures. Hypomagnesemia and afebrile seizures should be treated with the goal of maintaining a magnesium concentration >0.65 mmol/L. Although rare, genetic causes of hypomagnesemia should be considered, once common causes of hypomagnesemia are ruled out. PMID:28503619

  12. 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…

  13. 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…

  14. MST1, a key player, in enhancing fast skeletal muscle atrophy.

    PubMed

    Wei, Bin; Dui, Wen; Liu, Dong; Xing, Yan; Yuan, Zengqiang; Ji, Guangju

    2013-02-01

    Skeletal muscle undergoes rapid atrophy upon denervation and the underlying mechanisms are complicated. FOXO3a has been implicated as a major mediator of muscle atrophy, but how its subcellular location and activity is controlled during the pathogenesis of muscle atrophy remains largely unknown. MST1 (Mammalian Sterile 20-like kinase 1) is identified as a central component of the Hippo signaling pathway. MST1 has been shown to mediate phosphorylation of FOXO3a at Ser207. Whether this MST1-FOXO signaling cascade exerts any functional consequence on cellular homeostasis remains to be investigated. We identified that MST1 kinase was expressed widely in skeletal muscles and was dramatically up-regulated in fast- but not slow-dominant skeletal muscles immediately following denervation. The results of our histological and biochemical studies demonstrated that deletion of MST1 significantly attenuated denervation-induced skeletal muscle wasting and decreased expression of Atrogin-1 and LC3 genes in fast-dominant skeletal muscles from three- to five-month-old adult mice. Further studies indicated that MST1, but not MST2, remarkably increased FOXO3a phosphorylation level at Ser207 and promoted its nuclear translocation in atrophic fast-dominant muscles. We have established that MST1 kinase plays an important role in regulating denervation-induced skeletal muscle atrophy. During the early stage of muscle atrophy, the up-regulated MST1 kinase promoted progression of neurogenic atrophy in fast-dominant skeletal muscles through activation of FOXO3a transcription factors.

  15. Melatonin alleviates postinfarction cardiac remodeling and dysfunction by inhibiting Mst1.

    PubMed

    Hu, Jianqiang; Zhang, Lei; Yang, Yang; Guo, Yanjie; Fan, Yanhong; Zhang, Mingming; Man, Wanrong; Gao, Erhe; Hu, Wei; Reiter, Russel J; Wang, Haichang; Sun, Dongdong

    2017-01-01

    Melatonin reportedly protects against several cardiovascular diseases including ischemia/reperfusion (I/R), atherosclerosis, and hypertension. The present study investigated the effects and mechanisms of melatonin on cardiomyocyte autophagy, apoptosis, and mitochondrial injury in the context of myocardial infarction (MI). We demonstrated that melatonin significantly alleviated cardiac dysfunction after MI. Four weeks after MI, echocardiography and Masson staining indicated that melatonin notably mitigated adverse left ventricle remodeling. The mechanism may be associated with increased autophagy, reduced apoptosis, and alleviated mitochondrial dysfunction. Furthermore, melatonin significantly inhibited Mst1 phosphorylation while promoting Sirt1 expression after MI, which indicates that Mst1/Sirt1 signaling may serve as the downstream target of melatonin. We thus constructed a MI model using Mst1 transgenic (Mst1 Tg) and Mst1 knockout (Mst1(-/-) ) mice. The absence of Mst1 abolished the favorable effects of melatonin on cardiac injury after MI. Consistently, melatonin administration did not further increase autophagy, decrease apoptosis, or alleviate mitochondrial integrity and biogenesis in Mst1 knockout mice subjected to MI injury. These results suggest that melatonin alleviates postinfarction cardiac remodeling and dysfunction by upregulating autophagy, decreasing apoptosis, and modulating mitochondrial integrity and biogenesis. The attributed mechanism involved, at least in part, Mst1/Sirt1 signaling. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. REVIEW OF ACTINIDE AND STRONTIUM LOADING DATA FOR MST AND MMST

    SciTech Connect

    Peters, T.; Hobbs, D.; Fink, S.

    2010-10-20

    SRNL reviewed the relevant data from MST and mMST fissile loading studies to determine if further studies were required. With respect to MST, SRNL found that the published results adequately bound the expected conditions that Small Column Ion Exchange (SCIX) process will operate under. The lack of strontium data does not represent an issue as strontium is not relevant to criticality. There is no threat to criticality safety from the lack of strontium loading data. However, SRNL proposes a single test with MST to ensure that future SCIX operations are conservatively bounded and strontium maximum loading is understood. With respect to attempts to maximally load mMST, SRNL's knowledge on actinide and strontium loading is limited to uranium behavior. mMST has a very weak affinity for uranium, and even extended contact time at high uranium concentration shows minimal loading onto mMST. This leaves questions about the ability to load plutonium, neptunium and strontium. SRNL proposes to perform two tests with mMST to ensure that questions on plutonium, neptunium, and strontium sorption are answered, as well as ensuring that future mMST operations are conservatively bounded.

  17. Reliability of seizure semiology in patients with 2 seizure foci.

    PubMed

    Rathke, Kevin M; Schäuble, Barbara; Fessler, A James; So, Elson L

    2011-06-01

    To determine whether seizure semiology is reliable in localizing and distinguishing seizures at 2 independent brain foci in the same patient. Two masked reviewers localized seizures from 2 foci by their clinical semiology and intracranial electroencephalograms (EEGs). Epilepsy monitoring unit of referral comprehensive epilepsy program. Seventeen consecutive patients (51 seizures) with sufficient video and intracranial EEG data were identified by reviewing medical records of 366 patients older than 10 years. The primary outcome measures were interobserver agreement between the 2 masked reviewers; the proportion of seizures localized by semiology; the proportion of localized seizures concordant with intracranial EEG localization; and comparison between concordant and nonconcordant seizures in latency of intracranial EEG seizure spread. Interobserver agreement was 41% (κ score, 0.16). Only 30 of 51 seizures (59%) were localized by seizure semiology. The focus localized by semiology was concordant with the location of intracranial EEG seizure onset in 16 of 30 seizures (53%). No significant difference was observed between concordant and nonconcordant seizures in relation to the speed with which the EEG discharge spread from the location of seizure onset to another lobar region (P = .09, Wilcoxon rank sum test). Clinical seizure semiology is not as useful as intracranial EEG in localizing seizure onset in patients with dual seizure foci.

  18. Prospective IS-MST radar. Potential and diagnostic capabilities

    NASA Astrophysics Data System (ADS)

    Potehin, Aleksandr; Medvedev, Andrey; Kushnarev, Dmitriy; Setov, Artyom; Lebedev, Valentin

    2016-09-01

    In the next few years, a new radar is planned to be built near Irkutsk. It should have capabilities of incoherent scatter (IS) radars and mesosphere-stratosphere-troposphere (MST) radars [Zherebtsov et al., 2011]. The IS-MST radar is a phased array of two separated antenna panels with a multichannel digital receiving system, which allows detailed space-time processing of backscattered signal. This paper describes characteristics, configuration, and capabilities of the antenna and transceiver systems of this radar. We estimate its potential in basic operating modes to study the ionosphere by the IS method at heights above 100 km and the atmosphere with the use of signals scattered from refractive index fluctuations, caused by turbulent mixing at heights below 100 km. The modeling shows that the radar will allow us to regularly measure neutral atmosphere parameters at heights up to 26 km as well as to observe mesosphere summer echoes at heights near 85 km in the presence of charged ice particles (an increase in Schmidt number) and mesosphere winter echoes at heights near 65 km with increasing background electron density. Evaluation of radar resources at the IS mode in two height ranges 100-600 and 600-2000 km demonstrates that in the daytime and with the accumulation time of 10 min, the upper boundaries of electron density and ionospheric plasma temperature are ~1500 and ~1300 km respectively, with the standard deviation of no more than 10 %. The upper boundary of plasma drift velocity is ~1100 km with the standard deviation of 45 m/s. The estimation of interferometric capabilities of the MST radar shows that it has a high sensitivity to objects of angular size near 7.5 arc min, and its potential accuracy in determining target angles can reach 40 arc sec.

  19. Eslicarbazepine acetate as adjunctive therapy in patients with uncontrolled partial-onset seizures: Results of a phase III, double-blind, randomized, placebo-controlled trial

    PubMed Central

    Sperling, Michael R; Abou-Khalil, Bassel; Harvey, Jay; Rogin, Joanne B; Biraben, Arnaud; Galimberti, Carlo A; Kowacs, Pedro A; Hong, Seung Bong; Cheng, Hailong; Blum, David; Nunes, Teresa; Soares-da-Silva, Patrício

    2015-01-01

    Objective To evaluate the efficacy and safety of adjunctive eslicarbazepine acetate (ESL) in patients with refractory partial-onset seizures. Methods This randomized, placebo-controlled, double-blind, parallel-group, phase III study was conducted at 173 centers in 19 countries, including the United States and Canada. Eligible patients were aged ≥16 years and had uncontrolled partial-onset seizures despite treatment with 1–2 antiepileptic drugs (AEDs). After an 8-week baseline period, patients were randomized to once-daily placebo (n = 226), ESL 800 mg (n = 216), or ESL 1,200 mg (n = 211). Following a 2-week titration period, patients received ESL 800 or 1,200 mg once-daily for 12 weeks. Seizure data were captured and documented using event-entry or daily entry diaries. Results Standardized seizure frequency (SSF) during the maintenance period (primary end point) was reduced with ESL 1,200 mg (p = 0.004), and there was a trend toward improvement with ESL 800 mg (p = 0.06), compared with placebo. When data for titration and maintenance periods were combined, ESL 800 mg (p = 0.001) and 1,200 mg (p < 0.001) both reduced SSF. There were no statistically significant interactions between treatment response and geographical region (p = 0.38) or diary version (p = 0.76). Responder rate (≥50% reduction in SSF) was significantly higher with ESL 1,200 mg (42.6%, p < 0.001) but not ESL 800 mg (30.5%, p = 0.07) than placebo (23.1%). Incidence of treatment-emergent adverse events (TEAEs) and TEAEs leading to discontinuation increased with ESL dose. The most common TEAEs were dizziness, somnolence, nausea, headache, and diplopia. Significance Adjunctive ESL 1,200 mg once-daily was more efficacious than placebo in adult patients with refractory partial-onset seizures. The once-daily 800 mg dose showed a marginal effect on SSF, but did not reach statistical significance. Both doses were well tolerated. Efficacy assessment was not affected by

  20. Locked modes and magnetic field errors in MST

    SciTech Connect

    Almagri, A.F.; Assadi, S.; Prager, S.C.; Sarff, J.S.; Kerst, D.W.

    1992-06-01

    In the MST reversed field pinch magnetic oscillations become stationary (locked) in the lab frame as a result of a process involving interactions between the modes, sawteeth, and field errors. Several helical modes become phase locked to each other to form a rotating localized disturbance, the disturbance locks to an impulsive field error generated at a sawtooth crash, the error fields grow monotonically after locking (perhaps due to an unstable interaction between the modes and field error), and over the tens of milliseconds of growth confinement degrades and the discharge eventually terminates. Field error control has been partially successful in eliminating locking.

  1. Further developments of EISCAT as an MST radar

    NASA Technical Reports Server (NTRS)

    Rottger, J.

    1984-01-01

    The principal capabilities of EISCAT as an MST radar were described. Since the VHF transmitter of the EISCAT system is not yet delivered, only the UHF system could be used for radar experiments. Considerable developments in the year 1983 have now strongly improved the reliability of the operations. Most of the experiments were and will be done to investigate the high latitude ionosphere and thermosphere, but some time was also devoted to observations of the lower and middle atmosphere, particularly during the MAP/WINE compaign.

  2. Seizure disorders: update of medical and dental considerations.

    PubMed

    Stoopler, Eric T; Sollecito, Thomas P; Greenberg, Martin S

    2003-01-01

    Seizure disorders and epilepsy represent neurologic conditions that commonly are seen among patients requiring dental treatment. When dentists possess a working knowledge of seizures, in addition to an understanding of updated therapies for seizure management and oral complications associated with pharmacological therapy, they are able to treat patients with these disorders more effectively. Neurologic consultations and selecting an appropriate venue for treatment may need to be addressed prior to treatment, depending on the level of seizure control. Laboratory tests designed to evaluate medication levels, leukocyte counts, and clotting ability also may be required. Frequent recall visits may be necessary for seizure disorder patients who display adverse oral complications from medication, such as gingival hypertrophy, xerostomia, and oral yeast infections.

  3. Epilepsy and Other Seizure Disorders in Children: Drug Management

    ERIC Educational Resources Information Center

    Thomas, John A.; Knotts, Glenn R.

    1976-01-01

    A teacher can be valuable in aiding the recognition of seizure patterns in children and in providing further insight into possible side effects of anticonvulsant therapy, which might occur to the child in the classroom. (JD)

  4. Strategies for successful management of older patients with seizures.

    PubMed

    Eisenschenk, S; Gilmore, R

    1999-12-01

    The incidence of seizures increases dramatically with age, making epilepsy in the older patient a common clinical presentation in the primary care practice. In the case of a single seizure or when the underlying cause can be corrected, antiepileptic drug (AED) therapy may not be warranted. For recurrent seizures, single AED therapy should be initiated at a low dose and gradually titrated upward. Control of seizure frequency is dependent on appropriate AED selection and compliance, drug-drug interactions, and minimization of side effects. Monitoring of AED serum levels is imperative for effective AED therapy. Conventional AEDs remain the standard initial anticonvulsants for epilepsy in older patients. The newer AEDs have demonstrated efficacy as adjunctive therapy and may offer reduced side-effect profiles and fewer drug-drug interactions.

  5. Epilepsy and Other Seizure Disorders in Children: Drug Management

    ERIC Educational Resources Information Center

    Thomas, John A.; Knotts, Glenn R.

    1976-01-01

    A teacher can be valuable in aiding the recognition of seizure patterns in children and in providing further insight into possible side effects of anticonvulsant therapy, which might occur to the child in the classroom. (JD)

  6. Treatment approach in a child with hysterical seizures superimposed on partial complex seizures.

    PubMed

    Parraga, H C; Kashani, J H

    1981-03-01

    This article reports the case of a 9 1/2 year old child with a history of psychomotor epilepsy which was uncontrolled by multiple anticonvulsant medications. When admitted to the psychiatric inpatient service, he was treated with a combination of pharmacological, behavioural and psychodynamically oriented approaches. A period of intensive family counseling was conducted to clarify the parents' concerns about causality of the seizures and methods for dealing with them. This combined approach led to a complete cessation of reported seizures and a decreased number and dosage of anticonvulsant medications. The authors discuss the reluctance of some physicians to accept the co-existence of neurogenic and psychogenic seizures in a given patient. Patients with pharmacologically uncontrolled seizures must be identified and accurately diagnosed (neurogenic and/or psychogenic) to prevent complication such as over-medication and to administer appropriate treatment. Multiple disciplinary therapy including psychodynamic, pharmacological, behavioural and educational approaches should be implemented.

  7. Paternal Involvement in Multisystemic Therapy: Effects on Adolescent Outcomes and Maternal Depression

    ERIC Educational Resources Information Center

    Gervan, Shannon; Granic, Isabela; Solomon, Tracy; Blokland, Kirsten; Ferguson, Bruce

    2012-01-01

    The association between paternal involvement in therapy, adolescent outcomes and maternal depression was examined within the context of Multisystemic Therapy (MST), an empirically supported, family- and community-based treatment for antisocial adolescents. Ninety-nine families were recruited from five mental health agencies providing MST. We…

  8. Paternal Involvement in Multisystemic Therapy: Effects on Adolescent Outcomes and Maternal Depression

    ERIC Educational Resources Information Center

    Gervan, Shannon; Granic, Isabela; Solomon, Tracy; Blokland, Kirsten; Ferguson, Bruce

    2012-01-01

    The association between paternal involvement in therapy, adolescent outcomes and maternal depression was examined within the context of Multisystemic Therapy (MST), an empirically supported, family- and community-based treatment for antisocial adolescents. Ninety-nine families were recruited from five mental health agencies providing MST. We…

  9. Ion Heating Anisotropy during Dynamo Activity in the MST RFP

    NASA Astrophysics Data System (ADS)

    den Hartog, D. J.; Chapman, J. T.; Craig, D.; Fiksel, G.; Fontana, P. W.

    1999-11-01

    MHD dynamo activity is large in the MST Reversed-Field Pinch during sawtooth crashes, and small otherwise. During a sawtooth crash, ion temperature increases rapidly to a level several times as high as the temperature between sawteeth, which itself can be larger than the electron temperature. Several theories have been developed to explain this ion heating, some indicating a possible asymmetry in perpendicular to parallel heating [C. G. Gimblett, Europhys. Lett. 11, 541 (1990); Z. Yoshida, Nucl. Fusion 31, 386 (1991); N. Mattor, P. W. Terry, and S. C. Prager, Comments Plasma Phys. Controlled Fusion 15, 65 (1992)]. In standard MST discharges, impurity ion temperature measured perpendicular to the magnetic field (T_⊥) is higher than impurity ion temperature parallel to the magnetic field (T_allel) during a sawtooth crash. Throughout the rest of the sawtooth cycle, T_⊥ <= T_allel. This is in contrast to results obtained on the EXTRAP-T2 RFP which showed T_⊥ < T_allel throughout the discharge [K. Sasaki et al., Plasma Phys. Control. Fusion 39, 333 (1997)

  10. Doppler effects on velocity spectra observed by MST radars

    NASA Technical Reports Server (NTRS)

    Scheffler, A. O.; Liu, C. H.

    1986-01-01

    Recently, wind data from mesophere-stratosphere-troposphere (MST) radars have been used to study the spectra of gravity waves in the atmosphere (Scheffler and Liu, 1985; VanZandt et al., 1985). Since MST radar measures the line-of-sight Doppler velocities, it senses the components of the wave-associated velocities along its beam directions. These components are related through the polarization relations which depend on the frequency and wave number of the wave. Therfore, the radar-observed velocity spectrum will be different from the original gravity-wave spectrum. Their relationship depends on the frequency and wave number of the wave as well as the propagation geometry. This relation can be used to interpret the observed data. It can also be used to test the assumption of gravity-wave spectrum (Scheffler and Liu, 1985). In deriving this relation, the background atmosphere has been assumed to be motionless. Obviously, the Doppler shift due to the background wind will change the shape of the gravity-wave power spectrum as well as its relation with the radar-observed spectrum. Here, researcher's investigate these changes.

  11. Impurity Profiles in the MST Reversed-Field Pinch

    NASA Astrophysics Data System (ADS)

    Woehrer, D.; den Hartog, D. J.; Chapman, J. T.

    1996-11-01

    We have spectroscopically measured the radial distribution of several impurities in the MST Reversed-Field Pinch plasma.(This work was supported by the U. S. Department of Energy.) For several years we have operated a passive high-speed Doppler spectrometer [D. J. Den Hartog and R. J. Fonck, Rev. Sci. Instrum. 65, 3238 (1994)] on MST to measure impurity flow velocity and ion temperature. We have evidence that the flow velocity radial profile has substantial structure, with the flow at the edge sometimes oppositely directed to that in the core. These measurements were taken by comparing the flow of an edge state (C III, for example) to a core state (C V). It is crucial that we precisely measure this flow profile and its variation during a sawtooth cycle. Therefore, we must accurately measure the location of the various emission shells of the impurity ionization states. This is being accomplished with an array of small f = 20 cm holographic grating monochromators. Light is coupled into them via separate fused silica fiber optic bundles from a radial array of light collection chords. We will make measurements of emission profiles from ions such as B III, B IV, C III, C V, and O V.

  12. Helical Equilibrium Reconstruction using V3FIT on MST

    NASA Astrophysics Data System (ADS)

    Koliner, J. J.; Chapman, B. E.; Sarff, J. S.; Anderson, J. K.; Capecchi, W.; Eilerman, S.; Reusch, J. A.; Hanson, J. D.; Cianciosa, M. R.; Terranova, D.

    2013-10-01

    Plasmas in the MST reversed field pinch bifurcate to a helical equilibrium, forming a Single Helical Axis (SHAx) at high plasma current (Ip ~ 500 kA) and low density (ne ~ 0.5 × 1019 m-3) . Modeling of these plasmas requires an equilibrium solver that does not assume axisymmetry. The V3FIT 3D equilibrium reconstruction code is applied to helical equilibria with diagnostic measurements as constraints. The 11-chord interferometer-polarimeter, 22-point Thomson scattering system, and 4-camera soft X-ray probes have been included in addition to external magnetics. Inputs have been adapted for MST's close-fitting conducting shell. Investigations into the role of shell eddy currents have been made, including comparison to eigenfunctions generated from the Newcomb equation. At the plasma boundary, ~60% of the static n = 5 toroidal field BT seen by magnetic probes is generated by currents in the shell. The generated VMEC equilibrium serves as the input for applications relevant to the 1 MW, 25 keV neutral beam injector. During beam injection, fast ion confinement is reduced in periods with a SHAx compared to axisymmetric plasmas. A single particle orbit code has been applied to calculate particle trajectories in the 3D case, confirming a strong influence of SHAx equilibria on fast ion orbits. EPM magnetic bursts terminate at the transition to SHAx. Alfvén continua have been generated to study this phenomenon with the reduced-MHD code STELLGAP. Work Supported by USDoE and NSF.

  13. Recent upgrades to MST's soft-x-ray spectroscopy diagnostic

    NASA Astrophysics Data System (ADS)

    Pandya, M. D.; Scherer, A. C.; Clark, J.; Dubois, A. M.; Almagri, A. F.; Chapman, B. E.

    2016-10-01

    In MST RFP plasmas, electron energization during tearing mode reconnection events was recently observed via soft-x-ray (sxr) emission. X-ray measurements from 3-25 keV during these short-lived (< 100 μs) events were achieved with a detector consisting of an avalanche photodiode and a 20 ns Gaussian shaping amplifier (GSA) whose output was digitized at 500 MHz. A radially resolved measurement of x-ray emission from 2-10 keV can also be made with an existing array of six Amptek XR-100CR sxr detectors, each comprised of a Si photodiode, a charge-sensitive preamplifier, a thermoelectric cooler, and a Cremat GSA CR-200-500ns having a pulse FWHM of about 1200 ns. One upgrade to this system entails a CR-200-25ns GSA which will reduce the FWHM to 60 ns. The digitization rate is also increased from 60 MHz to 240 MHz, sufficient to resolve a 60 ns Gaussian pulse. The upgrade will also incorporate improved shielding from IGBT switching noise arising from MST's Bt and Bp programmable power supplies. Housing the detector assembly within Compac-SRF-series enclosures attenuates noise at 20 MHz by 80 dB. Initial measurements will be presented. Work supported by US DOE.

  14. A Role for MST Neurons in Heading Estimation

    NASA Technical Reports Server (NTRS)

    Stone, Leland Scott; Perrone, J. A.; Wade, Charles E. (Technical Monitor)

    1994-01-01

    A template model of human visual self-motion perception (Perrone, JOSA, 1992; Perrone & Stone, Vis. Res., in press), which uses neurophysiologically realistic "heading detectors", is consistent with numerous human psychophysical results (Warren & Hannon, Nature, 1988; Stone & Perrone, Neuro. Abstr., 1991) including the failure of humans to estimate their heading (direction of forward translation) accurately under certain visual conditions (Royden et al., Nature, 1992). We tested the model detectors with stimuli used by others in- single-unit studies. The detectors showed emergent properties similar to those of MST neurons: 1) Sensitivity to non-preferred flow. Each detector is tuned to a specific combination of flow components and its response is systematically reduced by the addition of nonpreferred flow (Orban et al., PNAS, 1992), and 2) Position invariance. The detectors maintain their apparent preference for particular flow components over large regions of their receptive fields (e.g. Duffy & Wurtz, J. Neurophys., 1991; Graziano et al., J. Neurosci., 1994). It has been argued that this latter property is incompatible with MST playing a role in heading perception. The model however demonstrates how neurons with the above response properties could still support accurate heading estimation within extrastriate cortical maps.

  15. 5. DETAIL VIEW OF NORTH FACE OF SLC3W MST WITH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. DETAIL VIEW OF NORTH FACE OF SLC-3W MST WITH ENVIRONMENTAL DOORS OPEN AND SERVICE PLATFORMS DOWN. SLC-3E MST IN BACKGROUND. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  16. The Development of MST Test Information for the Prediction of Test Performances

    ERIC Educational Resources Information Center

    Park, Ryoungsun; Kim, Jiseon; Chung, Hyewon; Dodd, Barbara G.

    2017-01-01

    The current study proposes novel methods to predict multistage testing (MST) performance without conducting simulations. This method, called MST test information, is based on analytic derivation of standard errors of ability estimates across theta levels. We compared standard errors derived analytically to the simulation results to demonstrate the…

  17. Regulation of neuronal cell death by MST1-FOXO1 signaling.

    PubMed

    Yuan, Zengqiang; Lehtinen, Maria K; Merlo, Paola; Villén, Judit; Gygi, Steven; Bonni, Azad

    2009-04-24

    The protein kinase mammalian Sterile 20-like kinase 1 (MST1) plays a critical role in the regulation of cell death. Recent studies suggest that MST1 mediates oxidative stress-induced neuronal cell death by phosphorylating the transcription factor FOXO3 at serine 207, a site that is conserved in other FOXO family members. Here, we show that MST1-induced phosphorylation of FOXO1 at serine 212, corresponding to serine 207 in FOXO3, disrupts the association of FOXO1 with 14-3-3 proteins. Accordingly, MST1 mediates the nuclear translocation of FOXO1 in primary rat cerebellar granule neurons that are deprived of neuronal activity. We also find a requirement for MST1 in cell death of granule neurons upon withdrawal of growth factors and neuronal activity, and MST1 induces cell death in a FOXO1-dependent manner. Finally, we show that the MST1-regulatory, scaffold protein Nore1 is required for survival factor deprivation induced neuronal death. Collectively, these findings define MST1-FOXO1 signaling as an important link survival factor deprivation-induced neuronal cell death with implications for our understanding of brain development and neurological diseases.

  18. Schizosaccharomyces pombe mst2+ Encodes a MYST Family Histone Acetyltransferase That Negatively Regulates Telomere Silencing†

    PubMed Central

    Gómez, Eliana B.; Espinosa, Joaquín M.; Forsburg, Susan L.

    2005-01-01

    Histone acetylation and deacetylation are associated with transcriptional activity and the formation of constitutively silent heterochromatin. Increasingly, histone acetylation is also implicated in other chromosome transactions, including replication and segregation. We have cloned the only Schizosaccharomyces pombe MYST family histone acetyltransferase genes, mst1+ and mst2+. Mst1p, but not Mst2p, is essential for viability. Both proteins are localized to the nucleus and bound to chromatin throughout the cell cycle. Δmst2 genetically interacts with mutants that affect heterochromatin, cohesion, and telomere structure. Mst2p is a negative regulator of silencing at the telomere but does not affect silencing in the centromere or mating type region. We generated a census of proteins and histone modifications at wild-type telomeres. A histone acetylation gradient at the telomeres is lost in Δmst2 cells without affecting the distribution of Taz1p, Swi6p, Rad21p, or Sir2p. We propose that the increased telomeric silencing is caused by histone hypoacetylation and/or an increase in the ratio of methylated to acetylated histones. Although telomere length is normal, meiosis is aberrant in Δmst2 diploid homozygote mutants, suggesting that telomeric histone acetylation contributes to normal meiotic progression. PMID:16199868

  19. Novel techniques for automated seizure registration: Patients' wants and needs.

    PubMed

    Hoppe, Christian; Feldmann, Mieke; Blachut, Barbara; Surges, Rainer; Elger, Christian E; Helmstaedter, Christoph

    2015-11-01

    Patient-reported seizure frequency is essential for therapy management and clinical research but lacks validity mainly due to seizure-induced seizure unawareness. Automated seizure detection by mobile monitoring devices promises to settle this serious methodological issue. Here, we explored attitudes and preferences towards future devices for seizure detection in adult patients with therapy-refractory epilepsies. A total of 102 inpatients enrolled and underwent a newly constructed semistructured 30-minute interview on automated seizure registration. Most patients would generally apply and permanently use seizure registration devices. Removable devices were preferred (e.g., wristband sensors), but also patch electrodes at invisible body sites appeared acceptable. Only a minority of patients would accept implantations for seizure registration (especially of depth electrodes). Also, permanent optical or acoustical surveillance were accepted by a few patients only. Most patients were ready to care for the device (e.g., charging battery), to have doctor's appointments for device control, and even to pay for the device. Seizure prediction was evaluated as an essential additional function. Only half of the patients wanted emergency calls in case of a seizure. Patients would accept automated seizure registration if the device had as little as possible negative effect on daily living. High acceptance might, therefore, be expected for hardware equipment as it is nowadays used by many healthy subjects for physiological self-monitoring and life-logging. The proper medical engineering task of the future, therefore, is to optimize sensors in those highly feasible devices and to establish reliable biomarkers and outcome measures for a diversity of diseases (including epilepsy) from data obtained by this generic hardware. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Improving Early Seizure Detection

    PubMed Central

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

    2011-01-01

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

  1. Grand Mal Seizure

    MedlinePlus

    ... from trauma, stroke, previous infection and other causes Sleep deprivation Medical problems that affect electrolyte balance Illicit drug ... Have you noticed any seizure triggers, such as sleep deprivation or illness? Medical history Your doctor will ask ...

  2. Temporal Lobe Seizure

    MedlinePlus

    ... some questions to ask include: Is the diagnosis epilepsy? Will more seizures occur? Will different types of ... by electrodes attached to your scalp. People with epilepsy often have changes in their brain wave patterns, ...

  3. MST1 functions as a key modulator of neurodegeneration in a mouse model of ALS

    PubMed Central

    Lee, Jae Keun; Shin, Jin Hee; Hwang, Sang Gil; Gwag, Byoung Joo; McKee, Ann C.; Lee, Junghee; Kowall, Neil W.; Ryu, Hoon; Lim, Dae-Sik; Choi, Eui-Ju

    2013-01-01

    Amyotrophic lateral sclerosis (ALS) is an adult-onset neurodegenerative disorder characterized by loss of motor neurons. Dominant mutations in the gene for superoxide dismutase 1 (SOD1) give rise to familial ALS by an unknown mechanism. Here we show that genetic deficiency of mammalian sterile 20-like kinase 1 (MST1) delays disease onset and extends survival in mice expressing the ALS-associated G93A mutant of human SOD1. SOD1(G93A) induces dissociation of MST1 from a redox protein thioredoxin-1 and promotes MST1 activation in spinal cord neurons in a reactive oxygen species–dependent manner. Moreover, MST1 was found to mediate SOD1(G93A)-induced activation of p38 mitogen-activated protein kinase and caspases as well as impairment of autophagy in spinal cord motoneurons of SOD1(G93A) mice. Our findings implicate MST1 as a key determinant of neurodegeneration in ALS. PMID:23818595

  4. 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

  5. Forecasting seizures in dogs with naturally occurring epilepsy.

    PubMed

    Howbert, J Jeffry; Patterson, Edward E; 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.

  6. Reflex operculoinsular seizures.

    PubMed

    Xiao, Handsun; Tran, Thi Phuoc Yen; Pétrin, Myriam; Boucher, Olivier; Mohamed, Ismail; Bouthillier, Alain; Nguyen, Dang Khoa

    2016-03-01

    Activation of specific cortical territories by certain stimuli is known to trigger focal seizures. We report three cases of well documented operculo-insular reflex seizures, triggered by somatosensory stimuli in two and loud noises in the third. Limited operculoinsular resection resulted in an excellent outcome for all. We discuss these observations in regard to the literature on reflex epilepsy and known functions of the insula. [Published with video sequences online].

  7. Seizures Following Cardiopulmonary Bypass

    PubMed Central

    Brouwer, Monique E.; McMeniman, William J.

    2016-01-01

    Abstract: Seizures following cardiopulmonary bypass are an immediate and alarming indication that a neurologic event has occurred. A case report of a 67-year-old man undergoing aortic valve surgery who unexpectedly experiences seizures following cardiopulmonary bypass is outlined. Possible contributing factors including atheromatous disease in the aorta, low cerebral perfusion pressures, an open-chamber procedure, and the use of tranexamic acid are identified. PMID:27729707

  8. Fibromyalgia and seizures.

    PubMed

    Tatum, William O; Langston, Michael E; Acton, Emily K

    2016-06-01

    The purpose of this case-matched study was to determine how frequently fibromyalgia is associated with different paroxysmal neurological disorders and explore the utility of fibromyalgia as a predictor for the diagnosis of psychogenic non-epileptic seizures. The billing diagnosis codes of 1,730 new, non-selected patient encounters were reviewed over a three-year period for an epileptologist in a neurology clinic to identify all patients with historical diagnoses of fibromyalgia. The frequency with which epileptic seizures, psychogenic non-epileptic seizures, and physiological non-epileptic events were comorbid with fibromyalgia was assessed. Age and gender case-matched controls were used for a between-group comparison. Wilcoxon tests were used to analyse interval data, and Chi-square was used to analyse categorical data (p<0.05). Fibromyalgia was retrospectively identified in 95/1,730 (5.5%) patients in this cohort. Females represented 95% of the fibromyalgia sample (age: 53 years; 95% CI: 57, 51). Forty-three percent of those with fibromyalgia had a non-paroxysmal, neurological primary clinical diagnosis, most commonly chronic pain. Paroxysmal events were present in 57% of fibromyalgia patients and 54% of case-matched controls. Among patients with fibromyalgia and paroxysmal disorders, 11% had epileptic seizures, 74% had psychogenic non-epileptic seizures, and 15% had physiological non-epileptic events, compared to case-matched controls with 37% epileptic seizures, 51% psychogenic non-epileptic events, and 12% physiological non-epileptic events (p = 0.009). Fibromyalgia was shown to be a predictor for the diagnosis of psychogenic non-epileptic seizures in patients with undifferentiated paroxysmal spells. However, our results suggest that the specificity and sensitivity of fibromyalgia as a marker for psychogenic non-epileptic seizures in a mixed general neurological population of patients is less than previously described.

  9. Glutamatergic Mechanisms Associated with Seizures and Epilepsy

    PubMed Central

    Barker-Haliski, Melissa; White, H. Steve

    2015-01-01

    Epilepsy is broadly characterized by aberrant neuronal excitability. Glutamate is the predominant excitatory neurotransmitter in the adult mammalian brain; thus, much of past epilepsy research has attempted to understand the role of glutamate in seizures and epilepsy. Seizures induce elevations in extracellular glutamate, which then contribute to excitotoxic damage. Chronic seizures can alter neuronal and glial expression of glutamate receptors and uptake transporters, further contributing to epileptogenesis. Evidence points to a shared glutamate pathology for epilepsy and other central nervous system (CNS) disorders, including depression, which is often a comorbidity of epilepsy. Therapies that target glutamatergic neurotransmission are available, but many have met with difficulty because of untoward adverse effects. Better understanding of this system has generated novel therapeutic targets that directly and indirectly modulate glutamatergic signaling. Thus, future efforts to manage the epileptic patient with glutamatergic-centric treatments now hold greater potential. PMID:26101204

  10. The body comes to family therapy: Treatment of a school-aged boy with hyperventilation-induced non-epileptic seizures.

    PubMed

    Kozlowska, Kasia; Chudleigh, Catherine; Elliott, Bronwen; Landini, Andrea

    2016-10-01

    We present the case of a 10-year-old boy, Evan, where a knock to the head activated memories of past bullying, causing intense distress, activation of the body's stress-regulation systems and recurrent hospital presentations with hyperventilation-induced non-epileptic seizures. We describe the initial assessment session that enabled Evan and his family to understand the context for Evan's non-epileptic seizures, to engage with the therapeutic team and to collaborate in the implementation of a mind-body multimodal family-based intervention. Once the physical symptoms had been addressed therapeutically, we explored possible dangers within the family and school systems and we worked with Evan and his family to increase his ability to access comfort and protection from his parents. Our short hospital intervention highlighted the importance of ongoing therapeutic work with Evan and the family and laid the foundation stones for the next part of the family's therapeutic journey. © The Author(s) 2015.

  11. Whole-exome sequencing identifies MST1R as a genetic susceptibility gene in nasopharyngeal carcinoma

    PubMed Central

    Dai, Wei; Zheng, Hong; Cheung, Arthur Kwok Leung; Tang, Clara Sze-man; Ko, Josephine Mun Yee; Wong, Bonnie Wing Yan; Leong, Merrin Man Long; Sham, Pak Chung; Cheung, Florence; Kwong, Dora Lai-Wan; Ngan, Roger Kai Cheong; Ng, Wai Tong; Yau, Chun Chung; Pan, Jianji; Peng, Xun; Tung, Stewart; Zhang, Zengfeng; Ji, Mingfang; Chiang, Alan Kwok-Shing; Lee, Anne Wing-Mui; Lee, Victor Ho-fun; Lam, Ka-On; Au, Kwok Hung; Cheng, Hoi Ching; Yiu, Harry Ho-Yin; Lung, Maria Li

    2016-01-01

    Multiple factors, including host genetics, environmental factors, and Epstein–Barr virus (EBV) infection, contribute to nasopharyngeal carcinoma (NPC) development. To identify genetic susceptibility genes for NPC, a whole-exome sequencing (WES) study was performed in 161 NPC cases and 895 controls of Southern Chinese descent. The gene-based burden test discovered an association between macrophage-stimulating 1 receptor (MST1R) and NPC. We identified 13 independent cases carrying the MST1R pathogenic heterozygous germ-line variants, and 53.8% of these cases were diagnosed with NPC aged at or even younger than 20 y, indicating that MST1R germ-line variants are relevant to disease early-age onset (EAO) (age of ≤20 y). In total, five MST1R missense variants were found in EAO cases but were rare in controls (EAO vs. control, 17.9% vs. 1.2%, P = 7.94 × 10−12). The validation study, including 2,160 cases and 2,433 controls, showed that the MST1R variant c.G917A:p.R306H is highly associated with NPC (odds ratio of 9.0). MST1R is predominantly expressed in the tissue-resident macrophages and is critical for innate immunity that protects organs from tissue damage and inflammation. Importantly, MST1R expression is detected in the ciliated epithelial cells in normal nasopharyngeal mucosa and plays a role in the cilia motility important for host defense. Although no somatic mutation of MST1R was identified in the sporadic NPC tumors, copy number alterations and promoter hypermethylation at MST1R were often observed. Our findings provide new insights into the pathogenesis of NPC by highlighting the involvement of the MST1R-mediated signaling pathways. PMID:26951679

  12. Seizure susceptibility due to antihistamines in febrile seizures.

    PubMed

    Takano, Tomoyuki; Sakaue, Yuko; Sokoda, Tatsuyuki; Sawai, Chihiro; Akabori, Shie; Maruo, Yoshihiro; Taga, Takashi; Ohno, Masaki; Takeuchi, Yoshihiro

    2010-04-01

    The aim of this study was to determine whether seizure susceptibility due to antihistamines is provoked in patients with febrile seizures. The study population comprised 14 patients with simple febrile seizures and 35 patients with complex febrile seizures. Detailed clinical manifestations were compared between patients with and without administration of antihistamine. The time from fever detection to the seizure onset was significantly shorter in the antihistamine group than that in the nonantihistamine group, and the duration of seizures was significantly longer in the antihistamine group than that in nonantihistamine group. Interleukin-1beta is thought to be associated with causing febrile seizures via its dual role as a pyrogen and convulsant substance. Moreover, interleukin-1beta may activate the turnover of hypothalamic neural histamine. These considerations, along with the present results, suggest that the depletion of hypothalamic neuronal histamine induced by antihistamines may increase neuronal excitability, thereby increasing seizure susceptibility in patients with febrile seizures. Copyright 2010 Elsevier Inc. All rights reserved.

  13. Consciousness of seizures and consciousness during seizures: are they related?

    PubMed

    Detyniecki, Kamil; Blumenfeld, Hal

    2014-01-01

    Recent advances have been made in the network mechanisms underlying impairment of consciousness during seizures. However, less is known about patient awareness of their own seizures. Studying patient reports or documentation of their seizures is currently the most commonly utilized mechanism to scientifically measure patient awareness of seizures. The purpose of this review is to summarize the available evidence regarding the accuracy of patient seizure counts and identify the variables that may influence unreliable seizure reporting. Several groups looking at patient documentation of seizures during continuous EEG monitoring show that patients do not report as many as 50% of their seizures. These studies also suggest that seizures accompanied by loss of consciousness, arising from the left hemisphere or the temporal lobe, or occurring during sleep are associated with significantly reduced reporting. Baseline memory performance does not appear to have a major influence on the accuracy of seizure report. Further prospective studies using validated ictal behavioral testing as well as using correlation with newer electrophysiological and neuroimaging techniques for seizure localization are needed to more fully understand the mechanisms of underreporting of seizures. Better methods to alert caregivers about unrecognized seizures and to improve seizure documentation are under investigation.

  14. Safety Profile of Eslicarbazepine Acetate as Add-On Therapy in Adults with Refractory Focal-Onset Seizures: From Clinical Studies to 6 Years of Post-Marketing Experience.

    PubMed

    Gama, Helena; Vieira, Mariana; Costa, Raquel; Graça, Joana; Magalhães, Luís M; Soares-da-Silva, Patrício

    2017-07-27

    Eslicarbazepine acetate was first approved in the European Union in 2009 as adjunctive therapy in adults with partial-onset seizures with or without secondary generalization. The objective of this study was to review the safety profile of eslicarbazepine acetate analyzing the data from several clinical studies to 6 years of post-marketing surveillance. We used a post-hoc pooled safety analysis of four phase III, double-blind, randomized, placebo-controlled studies (BIA-2093-301, -302, -303, -304) of eslicarbazepine acetate as add-on therapy in adults. Safety data of eslicarbazepine acetate in special populations of patients aged ≥65 years with partial-onset seizures (BIA-2093-401) and subjects with moderate hepatic impairment (BIA-2093-111) and renal impairment (BIA-2093-112) are also considered. The incidences of treatment-emergent adverse events, treatment-emergent adverse events leading to discontinuation, and serious adverse events were analyzed. The global safety database of eslicarbazepine acetate was analyzed for all cases from post-marketing surveillance from 1 October, 2009 to 21 October, 2015. From a pooled analysis of four phase III studies, it was concluded that the incidence of treatment-emergent adverse events, treatment-emergent adverse events leading to discontinuation, and adverse drug reactions were dose dependent. Dizziness, somnolence, headache, and nausea were the most common treatment-emergent adverse events (≥10% of patients) and the majority were of mild-to-moderate intensity. No dose-dependent trend was observed for serious adverse events and individual serious adverse events were reported in less than 1% of patients. Hyponatremia was classified as a possibly related treatment-emergent adverse event in phase III studies (1.2%); however, after 6 years of post-marketing surveillance it represents the most frequently (10.2%) reported adverse drug reaction, with more than half of these cases occurring with eslicarbazepine acetate at

  15. DESORPTION OF SORBATES FROM MST, MMST, AND CST UNDER VARIOUS CONDITIONS

    SciTech Connect

    Taylor-Pashow, K.; Hobbs, D.

    2011-06-10

    The Small Column Ion Exchange (SCIX) Program (formerly referred to as the Modular Salt Processing (MSP) Project) seeks to deploy equipment to remove the {sup 134,137}Cs, {sup 90}Sr, and alpha-emitting radionuclides (principally {sup 238,239,240}Pu and {sup 237}Np) from the high level waste salt solutions. The equipment is installed within a high level waste tank to take advantage of the shielding provided by the waste tank. The process will involve adding monosodium titanate (MST) to the waste tank (i.e., Tank 41H) to sorb the Sr and select actinides, removing the MST and entrained sludge with in-riser rotary microfilters, and subsequently using ion-exchange columns containing crystalline silicotitanate (CST) to remove the Cs. After being loaded with Cs, the CST will be ground to reduce the particle size and then transferred into another waste tank (e.g., Tank 40H). The MST and sludge solids stream will be transported to a sludge batch preparation tank (i.e., Tank 42H or Tank 51H) once the SCIX batch is processed. Both streams, MST/solids and CST, will ultimately be transported into and vitrified inside the Defense Waste Processing Facility (DWPF). A series of experiments were performed to examine desorption from monosodium titanate (MST), modified monosodium titanate (mMST), and crystalline silicotitanate (CST) under various conditions. The first two experiments examined desorption from MST and CST under two different sludge treatment processes, aluminum dissolution and sludge washing. Desorption of all sorbates was observed to varying degrees under the aluminum dissolution conditions. The extent of desorption ranged from < 3% to about 50% after 4 weeks, with Pu exhibiting the lowest desorption. At the end of the experiment, the temperature was reduced from 65 C to 25 C and the tests monitored for an additional two weeks. After reducing the temperature, partial resorption of the sorbates was observed with both MST and CST. Under the sludge washing conditions, no

  16. Fever, febrile seizures and epilepsy.

    PubMed

    Dubé, Céline M; Brewster, Amy L; Richichi, Cristina; Zha, Qinqin; Baram, Tallie Z

    2007-10-01

    Seizures induced by fever (febrile seizures) are the most common type of pathological brain activity in infants and children. These febrile seizures and their potential contribution to the mechanisms of limbic (temporal lobe) epilepsy have been a topic of major clinical and scientific interest. Key questions include the mechanisms by which fever generates seizures, the effects of long febrile seizures on neuronal function and the potential contribution of these seizures to epilepsy. This review builds on recent advances derived from animal models and summarizes our current knowledge of the mechanisms underlying febrile seizures and of changes in neuronal gene expression and function that facilitate the enduring effects of prolonged febrile seizures on neuronal and network excitability. The review also discusses the relevance of these findings to the general mechanisms of epileptogenesis during development and points out gaps in our knowledge, including the relationship of animal models to human febrile seizures and epilepsy.

  17. Fever, febrile seizures and epilepsy

    PubMed Central

    Dubé, Céline M.; Brewster, Amy L.; Richichi, Cristina; Zha, Qinqin; Baram, Tallie Z.

    2009-01-01

    Seizures induced by fever (febrile seizures) are the most common type of pathological brain activity in infants and children. These febrile seizures and their potential contribution to the mechanisms of limbic (temporal lobe) epilepsy have been a topic of major clinical and scientific interest. Key questions include the mechanisms by which fever generates seizures, the effects of long febrile seizures on neuronal function and the potential contribution of these seizures to epilepsy. This review builds on recent advances derived from animal models and summarizes our current knowledge of the mechanisms underlying febrile seizures and of changes in neuronal gene expression and function that facilitate the enduring effects of prolonged febrile seizures on neuronal and network excitability. The review also discusses the relevance of these findings to the general mechanisms of epileptogenesis during development and points out gaps in our knowledge, including the relationship of animal models to human febrile seizures and epilepsy. PMID:17897728

  18. Seizures in Alzheimer's disease.

    PubMed

    Born, H A

    2015-02-12

    Alzheimer's disease (AD) increases the risk for late-onset seizures and neuronal network abnormalities. An elevated co-occurrence of AD and seizures has been established in the more prevalent sporadic form of AD. Recent evidence suggests that nonconvulsive network abnormalities, including seizures and other electroencephalographic abnormalities, may be more commonly found in patients than previously thought. Patients with familial AD are at an even greater risk for seizures, which have been found in patients with mutations in PSEN1, PSEN2, or APP, as well as with APP duplication. This review also provides an overview of seizure and electroencephalography studies in AD mouse models. The amyloid-β (Aβ) peptide has been identified as a possible link between AD and seizures, and while Aβ is known to affect neuronal activity, the full-length amyloid precursor protein (APP) and other APP cleavage products may be important for the development and maintenance of cortical network hyperexcitability. Nonconvulsive epileptiform activity, such as seizures or network abnormalities that are shorter in duration but may occur with higher frequency, may contribute to cognitive impairments characteristic of AD, such as amnestic wandering. Finally, the review discusses recent studies using antiepileptic drugs to rescue cognitive deficits in AD mouse models and human patients. Understanding the mechanistic link between epileptiform activity and AD is a research area of growing interest. Further understanding of the connection between neuronal hyperexcitability and Alzheimer's as well as the potential role of epileptiform activity in the progression of AD will be beneficial for improving treatment strategies. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  19. Pervasive seizures caused by hypoxic-ischemic encephalopathy: treatment with intravenous paraldehyde.

    PubMed

    Armstrong, D L; Battin, M R

    2001-12-01

    Seizures are commonly associated with hypoxic-ischemic encephalopathy. Although the majority of cases are controlled with first- or second-line therapy, others develop pervasive seizures, requiring multiple anticonvulsants. To provide data on the incidence of seizures and response to anticonvulsant therapies, a cohort of 90 term infants with hypoxic-ischemic encephalopathy treated at our institution between January 1, 1995, and July 1, 1999, was reviewed. Of the 60 infants who developed seizures, 59 received phenobarbital initially; in 29 cases, the seizures resolved. The remaining 30 infants received phenytoin as a second-line anticonvulsant, and seizures stopped in 10 cases. The 20 infants with ongoing pervasive seizures were treated with intravenous paraldehyde.

  20. Momentum and Current Transport in the MST Reversed Field Pinch

    NASA Astrophysics Data System (ADS)

    Ding, W. X.; Lin, Liang; Brower, D. L.; Almagri, A. F.; Chapman, B. E.; Hartog, D. J. Den; Duff, J.; Sarff, J. S.

    2013-10-01

    Self-generated flows and current (dynamo effects) are routinely observed in the MST RFP where both parallel flow and electric field reverse sign compared to the edge. In the absence of external torque and applied poloidal electric field, both the flow and electric field may arise from kinetic effects. Kinetic effects, defined as the correlated product of parallel pressure and radial magnetic field fluctuations, have been measured by using a high-speed polarimetry-interferometry diagnostic (for combined radial magnetic field and density fluctuation measurement). Between sawtooth crashes it is found that the measured kinetic effects associated with density fluctuations (a component of parallel pressure fluctuation) has a finite amplitude that may account for the observed flow in the core. In addition, the same fluctuations also influence electron dynamics via the kinetic dynamo. These results suggest kinetic effects may play an important role in coupling between momentum transport and current transport. Work supported by US DOE and NSF.

  1. The MST radar technique: Requirements for operational weather forecasting

    NASA Technical Reports Server (NTRS)

    Larsen, M. F.

    1983-01-01

    There is a feeling that the accuracy of mesoscale forecasts for spatial scales of less than 1000 km and time scales of less than 12 hours can be improved significantly if resources are applied to the problem in an intensive effort over the next decade. Since the most dangerous and damaging types of weather occur at these scales, there are major advantages to be gained if such a program is successful. The interest in improving short term forecasting is evident. The technology at the present time is sufficiently developed, both in terms of new observing systems and the computing power to handle the observations, to warrant an intensive effort to improve stormscale forecasting. An assessment of the extent to which the so-called MST radar technique fulfills the requirements for an operational mesoscale observing network is reviewed and the extent to which improvements in various types of forecasting could be expected if such a network is put into operation are delineated.

  2. Neutral beam heating of a RFP plasma in MST

    SciTech Connect

    Waksman, J.; Anderson, J. K.; Nornberg, M. D.; Parke, E.; Reusch, J. A.; Liu, D.; Fiksel, G.; Davydenko, V. I.; Ivanov, A. A.; Stupishin, N.; Deichuli, P. P.; Sakakita, H.

    2012-12-15

    Electron temperature is observed to rise due to neutral beam injection (NBI) in the Madison Symmetric Torus (MST). Heating is observed to be 100 {+-} 50 eV in the core of 200 kA plasmas. This is the first definitive measurement of auxiliary heating of a reversed-field pinch (RFP). This heating is consistent with a 1D classical model which was developed. This 1D model calculates the evolving thermal conductivity and ohmic power input profiles during enhanced confinement, and can calculate NBI deposition and classical fast ion diffusion and slowing. The predicted temperature change is consistent with measured beam heating both during and after enhanced confinement, which is consistent with previous observations that fast ions are well confined and behave roughly classically in the RFP.

  3. Discrimination against interfering signals at the Poker Flat MST radar

    NASA Technical Reports Server (NTRS)

    Carter, D. A.

    1983-01-01

    Several on line and off line data processing techniques are used to remove interfering signals due to ground clutter, aircraft, instrumental effects, and external transmissions from the desired atmospheric echoes of Mesosphere Stratosphere, Troposphere (MST) radar. The on line, real time techniques are necessarily simple in order to minimize processing delays. This algorithm examines the individual Doppler spectra which are computed every two to four seconds (for oblique antenna beams). The total spectral power in each individual spectrum is computed by summing all the spectral points. If this integrated power increases from one spectrum to the next by a factor greater than a preselected threshold, then that spectrum is not added to the spectral sum. Succeeding spectra are compared to the last acceptable spectrum. Only a certain maximum number of spectra are allowed to be rejected in succession.

  4. Capabilities and limitations of existing MST radars: Poker Flat. [Alaska

    NASA Technical Reports Server (NTRS)

    Balsley, B. B.; Ecklund, W. L.; Carter, D. A.

    1983-01-01

    Designed as a prototype system to continuously monitor the atmosphere up to approximately 100 km, the Poker Flat MST radar began operating in 1979 at a relatively low sensitivity. In almost continuous operation since then, the system is steadily increasing in sensitivity to its ultimate design characteristics. Current and final parameters are listed. The advantages of its modular design, which uses 64 transmitting modules distributed through the 200 mx 200 m antenna array include: easy maintenance, beam switching using very low power switching, air cooled transmitting tubes, lower feedline costs, and no moving parts. Continuous, uninterrupted operation ( 4 years) and less man-made interference because of the remote location) are other assets. Most disadvantages are related to its not-yet-finished status, climate, moose excursions, and operating expenses.

  5. Time-resolved measurements of equilibrium profiles in MST

    NASA Astrophysics Data System (ADS)

    Deng, B. H.; Brower, D. L.; Ding, W. X.; Yates, T. F.; Anderson, J. K.; Caspary, K.; McCollam, K. J.; Prager, S. C.; Reusch, J. A.; Sarff, J. S.; Craig, D.

    2007-11-01

    Based on the high-speed, three-wave, far-infrared polarimeter-interferometer measurement of Bpol profiles and external coil measurements of Btave and Btw, a new method is developed to derive Btor and other equilibrium profiles (J// and q) with high time resolution. Using Faraday's law, the inductive electric field (E//) profile is also deduced from the temporal derivatives of the time-resolved magnetic field profiles. The derived B(0) values have excellent agreement with direct measurements using a Motional Stark Effect (MSE) diagnostic. Evolution of equilibrium profiles during single sawtooth events in MST, both the slow linear ramp and crash phases, are presented. Profile scaling with plasma current Ip and reversal parameter F is also explored. MHD stability is tested from the spatial gradients of the J// and q profiles, and correlation with fluctuation mode amplitude is investigated. Future improvements to equilibrium reconstruction are expected by measuring Btor(r,t) directly via Cotton-Mouton interferometry.

  6. Interdigital Line Antennas for Launching LH Waves in MST

    NASA Astrophysics Data System (ADS)

    Thomas, M. A.; Goetz, J. A.; Oliva, S. P.

    2002-11-01

    RF current drive has been proposed as a method for reducing the tearing fluctuations that are responsible for anomalous energy transport in the RFP. A system for launching lower hybrid slow waves at 800 MHz and n_||= 7.5 is now in operation on MST. The antenna is an enclosed interdigital line using λ/4 resonators with an opening in the cavity through which the wave is coupled to the plasma. A new antenna has been built incorporating several design improvements. These include larger vacuum feedthroughs, better impedance matching, internal instrumentation and improved directionality. Power handling is 3-4 times that of the original and continues to improve with conditioning. Further design improvements are underway to optimize impedance matching and damping rate along the traveling wave structure.

  7. Interpretation of MST radar returns from clear air

    NASA Technical Reports Server (NTRS)

    Liu, C. H.

    1983-01-01

    The nature of the scattering and reflection mechanisms that give rise to the MST radar echoes from the clear air is essential in the correct interpretation of the data about winds, waves, turbulence and stability in the atmosphere. There are two main aspects: the nature of the targets the radar sees and their generation mechanisms; and the signatures of the radar signals returned from the different targets. Volume scatterings from isotropic or anisotropic turbulence, and partial reflections from horizontally stratified, sharp refractive index gradients are believed the main contributors to radar echoes. Combined effects from all the mechanisms probably produce the observed data. The signature of the echo signals for these different scatterers under realistic experimental conditions should be studied. It is hoped from these studies, the nature of the targets can be better understood, and related to atmospheric dynamic processes.

  8. Feeder line fault detection in the Indian MST radar

    NASA Astrophysics Data System (ADS)

    Sarkar, B. K.

    1993-08-01

    The MST Radar uses semi-rigid cables and directional couplers for feeding power from the transmitters to the antennas. Coaxial directional couplers used in the feeder network are made of aluminum. Since the feeder network is exposed to the sun, it heats up and expands its length. At night the feeder network cools down and the coaxial directional couplers contract in length. Due to the expansion and contraction, sometimes it is found that the contact between the center conductors of two consecutive directional couplers are separated and thereby make part of the antenna array ineffective. Contact between directional couplers may be broken also due to oxidation of aluminum. Although steps are taken to remove this problem using anti-corrosive grease, it is worthwhile to monitor the 'health' of the feeder line from time to time. A measurement scheme is suggested which helps to detect the faulty contact of the directional couplers and the location of the fault.

  9. Prevalence of seizures in children infected with human immunodeficiency virus.

    PubMed

    Samia, Pauline; Petersen, Reneva; Walker, Kathleen G; Eley, Brian; Wilmshurst, Jo M

    2013-03-01

    A retrospective study of 354 human immunodeficiency virus (HIV)-infected patients identified a subgroup of 27 children with seizures (7.6%, 95% confidence interval: 5.1%-10.9%). Of the total group, 13% (n = 46) had identifiable neurologic deficits and 30% (n = 107) had developmental delay. Both observations were significantly more frequent in the subgroup of patients with seizures (P < .001). The median age of patients with seizures was 20 months (range, 8-87 months) and the median baseline CD4 percentage was 13.5% (interquartile range, 8%-23%). Seizures were treated with sodium valproate (n = 11), phenobarbital (n = 3), diazepam (n = 2), lamotrigine (n = 1), and carbamazepine (n = 1). Combination therapy was required for 5 children. Suboptimal valproic acid levels were recorded for 3 patients. When resources are available, antiepileptic drug level monitoring is advised for children who require both antiepileptic and antiretroviral medications to facilitate optimal seizure management.

  10. Sex and Hormonal influences on Seizures and Epilepsy

    PubMed Central

    Velíšková, Jana; DeSantis, Kara A.

    2012-01-01

    Epilepsy is the third most common chronic neurological disorder. Clinical and experimental evidence supports the role of sex and influence of sex hormones on seizures and epilepsy as well as alterations of the endocrine system and levels of sex hormones by epileptiform activity. Conversely, seizures are sensitive to changes in sex hormone levels, which in turn may affect the seizure-induced neuronal damage. The effects of reproductive hormones on neuronal excitability and seizure-induced damage are complex to contradictory and depend on different mechanisms, which have to be accounted for in data interpretation. Both estradiol and progesterone/allopregnanolone may have beneficial effects for patients with epilepsy. Individualized hormonal therapy should be considered as adjunctive treatment in patients with epilepsy to improve seizure control as well as quality of life. PMID:22504305

  11. Structural basis of the heterodimerization of the MST and RASSF SARAH domains in the Hippo signalling pathway

    SciTech Connect

    Hwang, Eunha; Cheong, Hae-Kap; Mushtaq, Ameeq Ul; Kim, Hye-Yeon; Yeo, Kwon Joo; Kim, Eunhee; Lee, Woo Cheol; Hwang, Kwang Yeon; Cheong, Chaejoon; Jeon, Young Ho

    2014-07-01

    The heterodimeric structure of the MST1 and RASSF5 SARAH domains is presented. A comparison of homodimeric and heterodimeric interactions provides a structural basis for the preferential association of the SARAH heterodimer. Despite recent progress in research on the Hippo signalling pathway, the structural information available in this area is extremely limited. Intriguingly, the homodimeric and heterodimeric interactions of mammalian sterile 20-like (MST) kinases through the so-called ‘SARAH’ (SAV/RASSF/HPO) domains play a critical role in cellular homeostasis, dictating the fate of the cell regarding cell proliferation or apoptosis. To understand the mechanism of the heterodimerization of SARAH domains, the three-dimensional structures of an MST1–RASSF5 SARAH heterodimer and an MST2 SARAH homodimer were determined by X-ray crystallography and were analysed together with that previously determined for the MST1 SARAH homodimer. While the structure of the MST2 homodimer resembled that of the MST1 homodimer, the MST1–RASSF5 heterodimer showed distinct structural features. Firstly, the six N-terminal residues (Asp432–Lys437), which correspond to the short N-terminal 3{sub 10}-helix h1 kinked from the h2 helix in the MST1 homodimer, were disordered. Furthermore, the MST1 SARAH domain in the MST1–RASSF5 complex showed a longer helical structure (Ser438–Lys480) than that in the MST1 homodimer (Val441–Lys480). Moreover, extensive polar and nonpolar contacts in the MST1–RASSF5 SARAH domain were identified which strengthen the interactions in the heterodimer in comparison to the interactions in the homodimer. Denaturation experiments performed using urea also indicated that the MST–RASSF heterodimers are substantially more stable than the MST homodimers. These findings provide structural insights into the role of the MST1–RASSF5 SARAH domain in apoptosis signalling.

  12. Runaway electrons and mitigation studies in MST tokamak plasmas

    NASA Astrophysics Data System (ADS)

    Goetz, J. A.; Chapman, B. E.; Almagri, A. F.; Cornille, B. S.; Dubois, A.; McCollam, K. J.; Munaretto, S.; Sovinec, C. R.

    2016-10-01

    Studies of runaway electrons generated in low-density MST tokamak plasmas are being undertaken. The plasmas have Bt <= 0.14 T, Ip <= 50 kA, q (a) = 2.2 , and an electron density and temperature of about 5 ×1017m-3 and 150 eV. Runaway electrons are detected via x-ray bremsstrahlung emission. The density and electric field thresholds for production and suppression have been previously explored with variations in gas puffing for density control. Runaway electrons are now being probed with resonant magnetic perturbations (RMP's). An m = 3 RMP strongly suppresses the runaway electrons and initial NIMROD modeling shows that this may be due to degradation of flux surfaces. The RMP is produced by a poloidal array of 32 saddle coils at the narrow vertical insulated cut in MST's thick conducting shell, with each RMP having a single m but a broad n spectrum. While a sufficiently strong m = 3 RMP suppresses the runaway electrons, an RMP with m = 1 and comparable amplitude has little effect. The impact of the RMP's on the magnetic topology of these plasmas is being studied with the nonlinear MHD code NIMROD. With an m = 3 RMP, stochasticity is introduced in the outer third of the plasma but no such flux surface degradation is observed with an m = 1 RMP. NIMROD also predicts regularly occurring MHD activity similar to that observed in the experiment. These studies have also been done in q (a) = 2.7 plasmas and analysis and modeling is ongoing. This work supported by USDoE.

  13. Lacosamide: A Review in Focal Seizures in Patients with Epilepsy.

    PubMed

    Scott, Lesley J

    2015-12-01

    Lacosamide (Vimpat(®)) is a functionalized amino acid available orally (as a solution or tablets) and as an intravenous infusion for use as monotherapy (only in the USA) or adjunctive therapy for the treatment of focal seizures in adult and adolescent (aged ≥17 years in the USA) patients with epilepsy. As adjunctive therapy to other antiepileptic drugs (AEDs), lacosamide provided effective seizure control and was generally well tolerated in adults and adolescents (aged ≥16 years) in randomized clinical trials and in the real-world setting. In clinical trials, adjunctive lacosamide provided significantly greater reductions in 28-day seizure rates than adjunctive placebo, with these benefits maintained after up to 8 years of therapy in open-label extension studies. Moreover, patients were effectively switched from oral to short-term intravenous adjunctive therapy at the same dosage, which may be particularly beneficial in situations where oral therapy is not suitable. Conversion to lacosamide monotherapy was superior to a historical-control cohort in patients with focal seizures converting from previous AED therapy. In the absence of head-to-head comparisons with other AEDs, the exact position of lacosamide relative to other AEDs remains to be fully determined. In the meantime, oral and intravenous lacosamide provides a useful option as monotherapy (only in the USA) or adjunctive therapy for the treatment of focal seizures in adult and adolescent (aged ≥17 years in the USA) patients with epilepsy.

  14. MST2 phosphorylation at serine 385 in mitosis inhibits its tumor suppressing activity.

    PubMed

    Chen, Xingcheng; Chen, Yuanhong; Dong, Jixin

    2016-12-01

    Mammalian sterile 20-like kinase 1/2 (MST1/2) are core tumor suppressors in the Hippo signaling pathway. MST1/2 have been shown to regulate mitotic progression. Here, we report a novel mechanism for phospho-regulation of MST2 in mitosis and its biological significance in cancer. We found that the mitotic kinase cyclin-dependent kinase 1 (CDK1) phosphorylates MST2 in vitro and in vivo at serine 385 during antimitotic drug-induced G2/M phase arrest. This phosphorylation occurs transiently during unperturbed mitosis. Mitotic phosphorylation of MST2 does not affect its kinase activity or Hippo-YAP signaling. We further showed that mitotic phosphorylation-deficient mutant MST2-S385A possesses higher activity in suppressing cell proliferation and anchorage-independent growth in vitro and tumorigenesis in vivo. Together, our findings reveal a novel layer of regulation for MST2 in mitosis and its role in tumorigenesis. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Mst1 shuts off cytosolic antiviral defense through IRF3 phosphorylation.

    PubMed

    Meng, Fansen; Zhou, Ruyuan; Wu, Shiying; Zhang, Qian; Jin, Qiuheng; Zhou, Yao; Plouffe, Steven W; Liu, Shengduo; Song, Hai; Xia, Zongping; Zhao, Bin; Ye, Sheng; Feng, Xin-Hua; Guan, Kun-Liang; Zou, Jian; Xu, Pinglong

    2016-05-01

    Cytosolic RNA/DNA sensing elicits primary defense against viral pathogens. Interferon regulatory factor 3 (IRF3), a key signal mediator/transcriptional factor of the antiviral-sensing pathway, is indispensible for interferon production and antiviral defense. However, how the status of IRF3 activation is controlled remains elusive. Through a functional screen of the human kinome, we found that mammalian sterile 20-like kinase 1 (Mst1), but not Mst2, profoundly inhibited cytosolic nucleic acid sensing. Mst1 associated with IRF3 and directly phosphorylated IRF3 at Thr75 and Thr253. This Mst1-mediated phosphorylation abolished activated IRF3 homodimerization, its occupancy on chromatin, and subsequent IRF3-mediated transcriptional responses. In addition, Mst1 also impeded virus-induced activation of TANK-binding kinase 1 (TBK1), further attenuating IRF3 activation. As a result, Mst1 depletion or ablation enabled an enhanced antiviral response and defense in cells and mice. Therefore, the identification of Mst1 as a novel physiological negative regulator of IRF3 activation provides mechanistic insights into innate antiviral defense and potential antiviral prevention strategies. © 2016 Meng et al.; Published by Cold Spring Harbor Laboratory Press.

  16. Mst1 shuts off cytosolic antiviral defense through IRF3 phosphorylation

    PubMed Central

    Meng, Fansen; Zhou, Ruyuan; Wu, Shiying; Zhang, Qian; Jin, Qiuheng; Zhou, Yao; Plouffe, Steven W.; Liu, Shengduo; Song, Hai; Xia, Zongping; Zhao, Bin; Ye, Sheng; Feng, Xin-Hua; Guan, Kun-Liang; Zou, Jian

    2016-01-01

    Cytosolic RNA/DNA sensing elicits primary defense against viral pathogens. Interferon regulatory factor 3 (IRF3), a key signal mediator/transcriptional factor of the antiviral-sensing pathway, is indispensible for interferon production and antiviral defense. However, how the status of IRF3 activation is controlled remains elusive. Through a functional screen of the human kinome, we found that mammalian sterile 20-like kinase 1 (Mst1), but not Mst2, profoundly inhibited cytosolic nucleic acid sensing. Mst1 associated with IRF3 and directly phosphorylated IRF3 at Thr75 and Thr253. This Mst1-mediated phosphorylation abolished activated IRF3 homodimerization, its occupancy on chromatin, and subsequent IRF3-mediated transcriptional responses. In addition, Mst1 also impeded virus-induced activation of TANK-binding kinase 1 (TBK1), further attenuating IRF3 activation. As a result, Mst1 depletion or ablation enabled an enhanced antiviral response and defense in cells and mice. Therefore, the identification of Mst1 as a novel physiological negative regulator of IRF3 activation provides mechanistic insights into innate antiviral defense and potential antiviral prevention strategies. PMID:27125670

  17. Mst1-mediated phosphorylation of Bcl-xL is required for myocardial reperfusion injury

    PubMed Central

    Zhai, Peiyong; Del Re, Dominic P.; Maejima, Yasuhiro

    2016-01-01

    Mst1 is a central Ser-Thr kinase in the Hippo pathway, which promotes apoptosis and inhibits cell proliferation. We have shown previously that, in cardiomyocytes, oxidative stress activates Mst1 at mitochondria, where Mst1 phosphorylates Bcl-xL at Ser14, inducing dissociation of Bcl-xL from Bax and thereby promoting apoptosis. However, the functional significance of Ser14 phosphorylation of endogenous Bcl-xL in vivo remains elusive. We generated knockin (KI) mice in which Ser14 of Bcl-xL is replaced with Ala. KI mice were born at the expected Mendelian ratio, and adult KI mice exhibited normal cardiac morphology and function at baseline. However, KI mice were protected from myocardial ischemia/reperfusion (I/R) injury and exhibited reduced cardiomyocyte apoptosis. Although suppression of endogenous Mst1 also reduced I/R injury, there was no additive protective effect when Mst1 was inhibited in KI mice. The development of dilated cardiomyopathy induced by cardiac-specific overexpression of Mst1 was also ameliorated in KI mice. Lats2 and YAP, two other key components of the Hippo pathway, were not affected in KI mice. These results suggest that Ser14 phosphorylation of Bcl-xL plays an essential role in mediating both cardiomyocyte apoptosis and myocardial injury by acting as a key downstream mediator of Mst1 independently of the canonical Hippo pathway. PMID:27218122

  18. Mst1 controls lymphocyte trafficking and interstitial motility within lymph nodes

    PubMed Central

    Katagiri, Koko; Katakai, Tomoya; Ebisuno, Yukihiko; Ueda, Yoshihiro; Okada, Takaharu; Kinashi, Tatsuo

    2009-01-01

    The regulation of lymphocyte adhesion and migration plays crucial roles in lymphocyte trafficking during immunosurveillance. However, our understanding of the intracellular signalling that regulates these processes is still limited. Here, we show that the Ste20-like kinase Mst1 plays crucial roles in lymphocyte trafficking in vivo. Mst1−/− lymphocytes exhibited an impairment of firm adhesion to high endothelial venules, resulting in an inefficient homing capacity. In vitro lymphocyte adhesion cascade assays under physiological shear flow revealed that the stopping time of Mst1−/− lymphocytes on endothelium was markedly reduced, whereas their L-selectin-dependent rolling/tethering and transition to LFA-1-mediated arrest were not affected. Mst1−/− lymphocytes were also defective in the stabilization of adhesion through α4 integrins. Consequently, Mst1−/− mice had hypotrophic peripheral lymphoid tissues and reduced marginal zone B cells and dendritic cells in the spleen, and defective emigration of single positive thymocytes. Furthermore, Mst1−/− lymphocytes had impaired motility over lymph node-derived stromal cells and within lymph nodes. Thus, our data indicate that Mst1 is a key enzyme involved in lymphocyte entry and interstitial migration. PMID:19339990

  19. Improving early seizure detection.

    PubMed

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

    2011-12-01

    Over the last decade, the search for a method able to reliably predict seizures hours in advance has been largely replaced by the more realistic goal of very early detection of seizure onset, which would allow therapeutic or warning devices to be triggered prior to the onset of disabling clinical symptoms. We explore in this article the steps along the pathway from data acquisition to closed-loop applications that can and should be considered to design the most efficient early seizure detection. Microelectrodes, high-frequency oscillations, high sampling rate, high-density arrays, and modern analysis techniques are all elements of the recording and detection process that in combination with modeling studies can provide new insights into the dynamics of seizure onsets. Each of these steps needs to be considered if detection devices that will favorably impact the quality of life of patients are to be implemented. This article is part of a Supplemental Special Issue entitled The Future of Automated Seizure Detection and Prediction. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Seizures in a Pediatric Intensive Care Unit: A Prospective Study

    PubMed Central

    Yazici, Mutlu Uysal; Ayar, Ganime; Karalok, Zeynep Selen; Arhan, Ebru Petek

    2016-01-01

    Background: The aim of the research is to determine the etiology and clinical features of seizures in critically ill children admitted to a pediatric intensive care unit (PICU). Methods: A total of 203 children were admitted from June 2013 to November 2013; 45 patients were eligible. Age ranged from 2 months to 19 years. Seizures were organized as epileptic or acute symptomatic. Pediatric risk of mortality score III, Glasgow coma scale, risk factors, coexistent diagnosis, medications administered before admission, type and duration of seizures, drugs used, requirement and duration of mechanical ventilation, length of stay and neuroimaging findings were collected as demographic data prospectively. Results: The male–female ratio was 0.8. Mean age was 5.4. The most common causes of seizures were acute symptomatic. Most frequent coexistent diagnosis was infectious diseases, and 53.3% had recurrent seizures. Medications were administered to 51.1% of the patients before admission. Seizures were focal in 21 (46.7%), generalized in 11 (24.4%) and 13 (28.9%) had status epilepticus. Intravenous midazolam was first-line therapy in 48.9%. Acute symptomatic seizures were usually new-onset, and duration was shorter. Epileptic seizures tended to be recurrent and were likely to progress to status epilepticus. However, type of seizures did not change severity of the disease. Also, laboratory test results, medications administered before admission, requirement and duration of ventilation, mortality and length of stay were not significant between epileptic/acute symptomatic patients. Conclusion: Seizures in critically ill children, which may evolve into status epilepticus, is an important condition that requires attention regardless of cause. Intensified educational programs for PICU physicians and international guidelines are necessary for a more efficient approach to children with seizures. PMID:26892503

  1. Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome.

    PubMed

    Glauser, T; Kluger, G; Sachdeo, R; Krauss, G; Perdomo, C; Arroyo, S

    2008-05-20

    Lennox-Gastaut syndrome is a catastrophic pediatric epilepsy syndrome characterized by multiple types of treatment-resistant seizures and high rates of seizure-related injury. Current available treatments are inadequate, leaving patients with few treatment options and opportunities. We conducted a double-blind, randomized, placebo-controlled trial of the antiepileptic drug rufinamide in patients with Lennox-Gastaut syndrome. Eligible patients between 4 and 30 years of age had multiple types of seizures (including tonic-atonic and atypical absence seizures) with a minimum of 90 seizures in the month before baseline and a recent history of a slow spike-and-wave pattern on EEG. After a 28-day baseline period, 139 eligible patients were randomized; 138 patients received either rufinamide (n = 74) or placebo (n = 64) in addition to their other antiepileptic drugs. The median percentage reduction in total seizure frequency was greater in the rufinamide therapy group than in the placebo group (32.7% vs 11.7%, p = 0.0015). There was a difference (p < 0.0001) in tonic-atonic ("drop attack") seizure frequency with rufinamide (42.5% median percentage reduction) vs placebo (1.4% increase). The rufinamide group had a greater improvement in seizure severity (p = 0.0041) and a higher 50% responder rate compared with placebo for total seizures (p = 0.0045) and tonic-atonic seizures (p = 0.002). The common adverse events (reported by >or=10% of patients receiving rufinamide) were somnolence (24.3% with rufinamide vs 12.5% with placebo) and vomiting (21.6% vs 6.3%). Rufinamide was an effective and well-tolerated treatment for seizures associated with Lennox-Gastaut syndrome.

  2. MST1, a key player, in enhancing fast skeletal muscle atrophy

    PubMed Central

    2013-01-01

    Background Skeletal muscle undergoes rapid atrophy upon denervation and the underlying mechanisms are complicated. FOXO3a has been implicated as a major mediator of muscle atrophy, but how its subcellular location and activity is controlled during the pathogenesis of muscle atrophy remains largely unknown. MST1 (Mammalian Sterile 20-like kinase 1) is identified as a central component of the Hippo signaling pathway. MST1 has been shown to mediate phosphorylation of FOXO3a at Ser207. Whether this MST1-FOXO signaling cascade exerts any functional consequence on cellular homeostasis remains to be investigated. Result We identified that MST1 kinase was expressed widely in skeletal muscles and was dramatically up-regulated in fast- but not slow-dominant skeletal muscles immediately following denervation. The results of our histological and biochemical studies demonstrated that deletion of MST1 significantly attenuated denervation-induced skeletal muscle wasting and decreased expression of Atrogin-1 and LC3 genes in fast-dominant skeletal muscles from three- to five-month-old adult mice. Further studies indicated that MST1, but not MST2, remarkably increased FOXO3a phosphorylation level at Ser207 and promoted its nuclear translocation in atrophic fast-dominant muscles. Conclusions We have established that MST1 kinase plays an important role in regulating denervation-induced skeletal muscle atrophy. During the early stage of muscle atrophy, the up-regulated MST1 kinase promoted progression of neurogenic atrophy in fast-dominant skeletal muscles through activation of FOXO3a transcription factors. PMID:23374633

  3. A conserved MST1/2-YAP axis mediates Hippo signaling during lung growth

    PubMed Central

    Lin, Chuwen; Yao, Erica; Chuang, Pao-Tien

    2015-01-01

    Hippo signaling is a critical player in controlling the growth of several tissues and organs in diverse species. The current model of Hippo signaling postulates a cascade of kinase activity initiated by the MST1/2 kinases in response to external stimuli. This leads to inactivation of the transcriptional coactivators, YAP/TAZ, due to their cytoplasmic retention and degradation that is correlated with YAP/TAZ phosphorylation. In most tissues examined, YAP plays a more dominant role than TAZ. Whether a conserved Hippo pathway is utilized during lung growth and development is unclear. In particular, the regulatory relationship between MST1/2 and YAP/TAZ in the lung remains controversial. By employing the Shh-Cre mouse line to efficiently inactivate genes in the lung epithelium, we show that loss of MST1/2 kinases in the epithelium can lead to neonatal lethality caused by lung defects. This is manifested by perturbation of lung epithelial cell proliferation and differentiation. These phenotypes are more severe than those produced by Nkx2.1-Cre, highlighting the effects of differential Cre activity on phenotypic outcomes. Importantly, expression of YAP targets is upregulated and the ratio of phospho-YAP to total YAP protein levels is reduced in Mst1/2-deficient lungs, all of which are consistent with a negative role of MST1/2 in controlling YAP function. This model gains further support from both in vivo and in vitro studies. Genetic removal of one allele of Yap or one copy of both Yap and Taz rescues neonatal lethality and lung phenotypes due to loss of Mst1/2. Moreover, knockdown of Yap in lung epithelial cell lines restores diminished alveolar marker expression caused by Mst1/2 inactivation. These results demonstrate that MST1/2 inhibit YAP/TAZ activity and establish a conserved MST1/2-YAP axis in coordinating lung growth during development. PMID:25912685

  4. Brain Stimulation Therapies

    MedlinePlus

    ... Magnetic Seizure Therapy Deep Brain Stimulation Additional Resources Brain Stimulation Therapies Overview Brain stimulation therapies can play ... for a shorter recovery time than ECT Deep Brain Stimulation Deep brain stimulation (DBS) was first developed ...

  5. New insight on antimicrobial therapy adjustment strategies for gram-negative bacterial infection

    PubMed Central

    Du, Wei; Chen, Hong; Xiao, Shuzhen; Tang, Wei; Shi, Guochao

    2017-01-01

    Abstract Gram-negative bacterial infections, especially multidrug-resistant (MDR) bacterial infection, are becoming a serious threat to public health. Although it is widely accepted that both appropriate initial empirical therapy and targeted therapy are important, but for patients needing therapy adjustment, few studies have explored whether adjustment strategy based on microbiologic susceptibility test (MST) brings better outcome compared with empirical adjustment. A total of 320 patients with gram-negative bacterial infection (airway, blood, or pleural effusion) were selected and a prospective cohort study was conducted. Baseline characteristics and outcomes (microbiologic, clinical, and economic) were documented during follow-up. MDR and nosocomial infections were common among subjects. Initial therapies consistent with MST could result in reduced in-hospital mortality, treatment failure rate, infection-related death, percentages of patients needing therapy adjustment, and daily hospitalization cost with increased successful treatment rate compared with inconsistent with MST, and microbiologic outcomes were also better with appropriate therapies. For patients needing therapy adjustment, relying on MST gained no significant benefit on mortality, clinical, or microbiologic outcomes compared with depending on clinical experience. But for patients with MDR infection, adjustment relying on MST gained more benefit than non-MDR infection. Appropriate initial therapy significantly improved the prognosis of patients with gram-negative bacterial infections, but improvement was not that obvious for patients needing therapy adjustment which was based on MST compared with clinical experience, and more beneficial effects of adjustment relying on MST were obtained for patients with MDR bacterial infection. PMID:28353572

  6. [Neonatal seizures management].

    PubMed

    Roubertie, A; Masson, F; de Villepin-Touzery, A; Suau, B; Barbanel, G; Rideau, A; Cambonie, G

    2011-07-01

    For several decades, experimental studies have sought to explain the biological causes of newborn seizures and to assess the anatomical and functional consequences. Laboratory studies have shown that prolonged or repeated seizures disturb central nervous system development and may predispose to later epilepsy or cognitive deficits. Although these findings have not been clinically demonstrated in humans, several observations suggest that neonatal seizures have a deleterious effect on the immature brain and generate long-term sequelae. No therapeutic trial, however, has directly demonstrated the benefits of treatment, underlining the need for controlled studies that integrate the advances in electroencephalographic monitoring and pharmacology of anticonvulsant drugs. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  7. Rates and Predictors of Seizure Freedom With Vagus Nerve Stimulation for Intractable Epilepsy

    PubMed Central

    Rolston, John D.; Wright, Clinton W.; Hassnain, Kevin H.; Chang, Edward F.

    2015-01-01

    BACKGROUND: Neuromodulation-based treatments have become increasingly important in epilepsy treatment. Most patients with epilepsy treated with neuromodulation do not achieve complete seizure freedom, and, therefore, previous studies of vagus nerve stimulation (VNS) therapy have focused instead on reduction of seizure frequency as a measure of treatment response. OBJECTIVE: To elucidate rates and predictors of seizure freedom with VNS. METHODS: We examined 5554 patients from the VNS therapy Patient Outcome Registry, and also performed a systematic review of the literature including 2869 patients across 78 studies. RESULTS: Registry data revealed a progressive increase over time in seizure freedom after VNS therapy. Overall, 49% of patients responded to VNS therapy 0 to 4 months after implantation (≥50% reduction seizure frequency), with 5.1% of patients becoming seizure-free, while 63% of patients were responders at 24 to 48 months, with 8.2% achieving seizure freedom. On multivariate analysis, seizure freedom was predicted by age of epilepsy onset >12 years (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.38-2.58), and predominantly generalized seizure type (OR, 1.36; 95% CI, 1.01-1.82), while overall response to VNS was predicted by nonlesional epilepsy (OR, 1.38; 95% CI, 1.06-1.81). Systematic literature review results were consistent with the registry analysis: At 0 to 4 months, 40.0% of patients had responded to VNS, with 2.6% becoming seizure-free, while at last follow-up, 60.1% of individuals were responders, with 8.0% achieving seizure freedom. CONCLUSION: Response and seizure freedom rates increase over time with VNS therapy, although complete seizure freedom is achieved in a small percentage of patients. ABBREVIATIONS: AED, antiepileptic drug VNS, vagus nerve stimulation PMID:26645965

  8. Rates and Predictors of Seizure Freedom With Vagus Nerve Stimulation for Intractable Epilepsy.

    PubMed

    Englot, Dario J; Rolston, John D; Wright, Clinton W; Hassnain, Kevin H; Chang, Edward F

    2016-09-01

    Neuromodulation-based treatments have become increasingly important in epilepsy treatment. Most patients with epilepsy treated with neuromodulation do not achieve complete seizure freedom, and, therefore, previous studies of vagus nerve stimulation (VNS) therapy have focused instead on reduction of seizure frequency as a measure of treatment response. To elucidate rates and predictors of seizure freedom with VNS. We examined 5554 patients from the VNS therapy Patient Outcome Registry, and also performed a systematic review of the literature including 2869 patients across 78 studies. Registry data revealed a progressive increase over time in seizure freedom after VNS therapy. Overall, 49% of patients responded to VNS therapy 0 to 4 months after implantation (≥50% reduction seizure frequency), with 5.1% of patients becoming seizure-free, while 63% of patients were responders at 24 to 48 months, with 8.2% achieving seizure freedom. On multivariate analysis, seizure freedom was predicted by age of epilepsy onset >12 years (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.38-2.58), and predominantly generalized seizure type (OR, 1.36; 95% CI, 1.01-1.82), while overall response to VNS was predicted by nonlesional epilepsy (OR, 1.38; 95% CI, 1.06-1.81). Systematic literature review results were consistent with the registry analysis: At 0 to 4 months, 40.0% of patients had responded to VNS, with 2.6% becoming seizure-free, while at last follow-up, 60.1% of individuals were responders, with 8.0% achieving seizure freedom. Response and seizure freedom rates increase over time with VNS therapy, although complete seizure freedom is achieved in a small percentage of patients. AED, antiepileptic drugVNS, vagus nerve stimulation.

  9. SEIZURE AND EPILEPSY: STUDIES OF SEIZURE DISORDERS IN DROSOPHILA

    PubMed Central

    Parker, Louise; Howlett, Iris C.; Rusan, Zeid M.; Tanouye, Mark A.

    2012-01-01

    Despite the frequency of seizure disorders in the human population, the genetic and physiological basis for these defects has been difficult to resolve. Although many genetic contributions to seizure susceptibility have been identified, these involve disparate biological processes, many of which are not neural specific. The large number and heterogeneous nature of the genes involved makes it difficult to understand the complex factors underlying the etiology of seizure disorders. Examining the effect known genetic mutations have on seizure susceptibility is one approach that may prove fruitful. This approach may be helpful in both understanding how different physiological processes affect seizure susceptibility and identifying novel therapeutic treatments. We review here factors contributing to seizure susceptibility in Drosophila, a genetically tractable system that provides a model for human seizure disorders. Seizure-like neuronal activities and behaviors in the fruit fly are described, as well as a set of mutations that exhibit features resembling some human epilepsies and render the fly sensitive to seizures. Especially interesting are descriptions of a novel class of mutations that are second-site mutations that act as seizure suppressors. These mutations revert epilepsy phenotypes back to the wild-type range of seizure susceptibility. The genes responsible for seizure suppression are cloned with the goal of identifying targets for lead compounds that may be developed into new antiepileptic drugs. PMID:21906534

  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 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…

  12. Triggers and techniques in termination of partial seizures.

    PubMed

    Dionisio, Jenna; Tatum, William O

    2010-02-01

    Growing interest in seizure prediction exists as a means to deliver newer antiepileptic therapies, though patient self-termination of seizures has received little attention. Two hundred twenty-three patients able to recognize seizure onset were surveyed in an outpatient epilepsy clinic. A seven-question survey administered prospectively assessed self-reported seizure prediction and clinical techniques used for self-termination. Survey responses targeted percentage predictability of seizures, timing of clinical prediction, likelihood/timing of termination, frequency and effectiveness of methods used, and perspectives of patient and physician belief in self-termination. Two hundred twenty-three patients (89 males) with a mean age of 42.7 years, average duration of epilepsy of 20.8 years and monthly mean seizure frequency of 4.1 comprised the study group. Thirty-eight percent completed >75% of the survey. Prior treatment included a mean of 6.0 AEDs (40/192 had surgery); 65% had ongoing seizures. Sixty percent of 223 patients reported a history of an aura, and 39% consistently noted auras for >75% of their current seizures. Of the patients with auras, seizure triggers were reported in 74%, with worry and stress (N=69), sleep deprivation (N=60), and missed medication (N=56) most frequently cited. Seventeen percent were positive/somewhat sure they could predict onset, with approximately 20% noting rapid onset in <15 seconds. Twenty-two of 82 noted that they had some ability to self-terminate their seizures, and 9% were positive that they could do so. Methods to self-terminate were effective (>75% certainty) in 35% (26/75). The primary methods were lying down/resting and taking extra medication. The majority of patients with partial seizures recognize triggers of seizure onset. In addition, more than one-third believe they can effectively self-terminate their partial-onset seizures. Lying down, resting, and taking extra medication were the most common techniques

  13. Classification of seizures and epilepsy.

    PubMed

    Riviello, James J

    2003-07-01

    The management of seizures and epilepsy begins with forming a differential diagnosis, making the diagnosis, and then classifying seizure type and epileptic syndrome. Classification guides treatment, including ancillary testing, management, prognosis, and if needed, selection of the appropriate antiepileptic drug (AED). Many AEDs are available, and certain seizure types or epilepsy syndromes respond to specific AEDs. The identification of the genetics, molecular basis, and pathophysiologic mechanisms of epilepsy has resulted from classification of specific epileptic syndromes. The classification system used by the International League Against Epilepsy is periodically revised. The proposed revision changes the classification emphasis from the anatomic origin of seizures (focal vs generalized) to seizure semiology (ie, the signs or clinical manifestations). Modified systems have been developed for specific circumstances (eg, neonatal seizures, infantile seizures, status epilepticus, and epilepsy surgery). This article reviews seizure and epilepsy classification, emphasizing new data.

  14. Factors associated with seizure occurrence and long-term seizure control in pediatric brain arteriovenous malformation: a retrospective analysis of 89 patients.

    PubMed

    Liu, Shuang; Chen, Hong-Xu; Mao, Qing; You, Chao; Xu, Jian-Guo

    2015-08-27

    Few studies have examined seizures in pediatric brain arteriovenous malformation. In our study, risk factors associated with seizure occurrence and long-term seizure control outcomes after different treatments in pediatric arteriovenous malformation patients were investigated. A retrospective analysis was conducted with clinical data from a cohort of 89 pediatric brain arteriovenous malformation patients acquired between 2008 and 2013. Univariate and multivariate analyses were used to assess risk factors associated with seizure incidence. Patients who presented with seizure before treatment were evaluated using the Engel classification during the follow-up period. A higher risk of seizure occurrence was observed in large size and unruptured brain arteriovenous malformations using multivariate logistic regression analysis (p < 0.05). A total of 22 children, who presented with seizure before the interventions, were included in subsequent analysis. During a mean follow-up period of 2.3 years after the intervention, 12 (55 %) of these children were classified as Engel class I after treatment. Seizures were the most common symptom in unruptured bAVMs. Size of the brain arteriovenous malformation is highly significant to seizure occurrence. Patients with cerebral hemorrhage are prone to having an acute seizure occurrence. The different therapies examined all improved seizure control to varying degrees.

  15. Seizure ending signs in patients with dyscognitive focal seizures.

    PubMed

    Gavvala, Jay R; Gerard, Elizabeth E; Macken, Mícheál; Schuele, Stephan U

    2015-09-01

    Signs indicating the end of a focal seizure with loss of awareness and/or responsiveness but without progression to focal or generalized motor symptoms are poorly defined and can be difficult to determine. Not recognizing the transition from ictal to postictal behaviour can affect seizure reporting accuracy by family members and may lead to delayed or a lack of examination during EEG monitoring, erroneous seizure localization and inadequate medical intervention for prolonged seizure duration. Our epilepsy monitoring unit database was searched for focal seizures without secondary generalization for the period from 2007 to 2011. The first focal seizure in a patient with loss of awareness and/or responsiveness and/or behavioural arrest, with or without automatisms, was included. Seizures without objective symptoms or inadequate video-EEG quality were excluded. A total of 67 patients were included, with an average age of 41.7 years. Thirty-six of the patients had seizures from the left hemisphere and 29 from the right. All patients showed an abrupt change in motor activity and resumed contact with the environment as a sign of clinical seizure ending. Specific ending signs (nose wiping, coughing, sighing, throat clearing, or laughter) were seen in 23 of 47 of temporal lobe seizures and 7 of 20 extra-temporal seizures. Seizure ending signs are often subtle and the most common finding is a sudden change in motor activity and resumption of contact with the environment. More distinct signs, such as nose wiping, coughing or throat clearing, are not specific to temporal lobe onset. A higher proportion of seizures during sleep went unexamined, compared to those during wakefulness. This demonstrates that seizure semiology can be very subtle and arousals from sleep during monitoring should alert staff. Patient accounts of seizure frequency appear to be unreliable and witness reports need to be taken into account. [Published with video sequences].

  16. Management of seizures in children.

    PubMed

    El-Radhi, A Sahib

    Seizures are common events in children and up to 10% of all children experience at least one seizure during their childhood. They can be triggered by many conditions such as fever, medications or injury. Febrile seizures are the most common types of seizures, affecting 3-4% of children. While epilepsy is typically recurrent and unprovoked, a single, isolated seizure is not epilepsy. Taking a detailed history of the seizure description helps establish the diagnosis. A video recording of the event can also support the diagnosis and rule out non-epileptic seizures that resemble seizures, such as pseudo-seizure. Seeing a child having a seizure, particularly if it is the first one, is usually frightening and distressing for the parents. First seizure should always be evaluated by health professionals because of a possible serious underlying cause. If the seizure occurs at home, the child should be placed in the recovery side position to prevent the swallowing of any vomit. The care of a child who does have epilepsy is best achieved by a community or hospital epilepsy specialist nurse. These nurses play a pivotal role in providing a close link between the epileptic children and their families. Such a nurse is also in an ideal position to establish a link between the doctor and affected families, offering valuable advice and support, and visiting the epileptic child at home.

  17. Feasibility study of a caregiver seizure alert system in canine epilepsy.

    PubMed

    Coles, Lisa D; Patterson, Edward E; Sheffield, W Douglas; Mavoori, Jaideep; Higgins, Jason; Michael, Bland; Leyde, Kent; Cloyd, James C; Litt, Brian; Vite, Charles; Worrell, Gregory A

    2013-10-01

    A device capable of detecting seizures and alerting caregivers would be a major advance for epilepsy management, and could be used to guide early intervention and prevent seizure-related injuries. The objective of this work was to evaluate a seizure advisory system (SAS) that alerts caregivers of seizures in canines with naturally occurring epilepsy. Four dogs with epilepsy were implanted with a SAS that wirelessly transmits continuous intracranial EEG (iEEG) to an external device embedded with a seizure detection algorithm and the capability to alert caregivers. In this study a veterinarian was alerted by automated text message if prolonged or repetitive seizures occurred, and a rescue therapy protocol was implemented. The performance of the SAS caregiver alert was evaluated over the course of 8 weeks. Following discontinuation of antiepileptic drugs, the dogs experienced spontaneous unprovoked partial seizures that secondarily generalized. Three prolonged or repetitive seizure episodes occurred in 2 of the dogs. On each occasion, the SAS caregiver alert successfully alerted an on call veterinarian who confirmed the seizure activity via remote video-monitoring. A rescue medication was then administered and the seizures were aborted. This study demonstrates the feasibility of a SAS to alert caregivers to the occurrence of prolonged or repetitive seizures and enables rescue medications to be delivered in a timely manner. The SAS may improve the management of human epilepsy by alerting caregivers of seizures, enabling early interventions, and potentially improving outcomes and quality of life of patients and caregivers.

  18. 6. DETAIL VIEW OF SOUTH FACE OF SLC3W MST WITH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. DETAIL VIEW OF SOUTH FACE OF SLC-3W MST WITH ENVIRONMENTAL DOORS OPEN AND SERVICE PLATFORMS DOWN - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  19. 8. VIEW OF NORTH FACE OF SLC3W MST WITH ENVIRONMENTAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. VIEW OF NORTH FACE OF SLC-3W MST WITH ENVIRONMENTAL DOORS OPEN AND SERVICE PLATFORMS RAISED - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  20. Mst1 is an interacting protein that mediates PHLPPs' induced apoptosis.

    PubMed

    Qiao, Meng; Wang, Yaqi; Xu, Xiaoen; Lu, Jing; Dong, Yongli; Tao, Wufan; Stein, Janet; Stein, Gary S; Iglehart, James D; Shi, Qian; Pardee, Arthur B

    2010-05-28

    PHLPP1 and PHLPP2 phosphatases exert their tumor-suppressing functions by dephosphorylation and inactivation of Akt in several breast cancer and glioblastoma cells. However, Akt, or other known targets of PHLPPs that include PKC and ERK, may not fully elucidate the physiological role of the multifunctional phosphatases, especially their powerful apoptosis induction function. Here, we show that PHLPPs induce apoptosis in cancer cells independent of the known targets of PHLPPs. We identified Mst1 as a binding partner that interacts with PHLPPs both in vivo and in vitro. PHLPPs dephosphorylate Mst1 on the T387 inhibitory site, which activate Mst1 and its downstream effectors p38 and JNK to induce apoptosis. The same T387 site can be phosphorylated by Akt. Thus, PHLPP, Akt, and Mst1 constitute an autoinhibitory triangle that controls the fine balance of apoptosis and proliferation that is cell type and context dependent.

  1. STABLE SR VS 85SR SORPTION FROM SIMULATED WASTE SOLUTIONS BY MST AND MMST

    SciTech Connect

    Taylor-Pashow, K.; Hobbs, D.

    2012-04-02

    A series of tests were performed to examine the sorption of stable Sr versus the sorption of {sup 85}Sr by monosodium titanate (MST) and modified monosodium titanate (mMST) from simulated waste solutions. Earlier testing indicated a discrepancy between the decontamination factors (DFs) obtained by measuring the stable Sr concentrations by inductively coupled plasma - mass spectroscopy (ICP-MS) and the {sup 85}Sr activities by gamma spectroscopy. One hypothesis to explain this discrepancy was that the stable Sr and {sup 85}Sr were in different chemical forms in the simulated solutions. Several simulants were prepared using different methods for adding the Sr and performance tests were carried out using MST and mMST to determine the Sr and {sup 85}Sr DFs with the various simulants. Testing indicated no discrepancy between the Sr and {sup 85}Sr DFs in tests with these simulants.

  2. The MST radar technique: A tool for investigations of turbulence spectra

    NASA Technical Reports Server (NTRS)

    Larsen, M. F.

    1983-01-01

    The feasibility of the MST radar as a tool for investigating turbulence spectra is discussed. Power spectral measurements using radar data are discussed. The characteristics of stratospheric turbulence are described. A model of the mesoscale turbulent process is developed.

  3. The Mitochondrial Replacement 'Therapy' Myth.

    PubMed

    Rulli, Tina

    2016-12-30

    This article argues that two forms of mitochondrial replacement therapy, maternal spindle transfer (MST) and pro-nuclear transfer (PNT), are not therapies at all because they do not treat children who are coming into existence. Rather, these technologies merely create healthy children where none was inevitable. Even if creating healthy lives has some value, it is not to be confused with the medical value of a cure or therapy. The article addresses a recent Bioethics article, 'Mitochondrial Replacement: Ethics and Identity,' by Wrigley, Wilkinson, and Appleby, who argue that PNT is morally favorable to MST due to the Non-Identity Problem. Wrigley et al. claim that PNT, since it occurs post-conception, preserves the identity of the resulting child, whereas MST, since it occurs pre-conception, is an identity-altering technique. As such, a child born with mitochondrial disease could complain that her parents failed to use PNT, but not MST. The present article argues that the authors are mistaken: both MST and PNT are identity-affecting techniques. But this is of little matter, for we should be cautious in drawing any moral conclusions from the application of the Non-Identity Problem to cases. The article then argues that the authors are mistaken in inferring that PNT is a type of embryonic cure or therapy for children with mitochondrial disease. The article cautions against the mistaken life-saving rhetoric that is common in bioethics discussions of MRTs.

  4. Outcome following neonatal seizures.

    PubMed

    Uria-Avellanal, Cristina; Marlow, Neil; Rennie, Janet M

    2013-08-01

    Neonatal seizures are the most common manifestation of neurological disorders in the newborn period and an important determinant of outcome. Overall, for babies born at full term, mortality following seizures has improved in the last decade, typical current mortality rates being 10% (range: 7-16%), down from 33% in reports from the 1990s. By contrast, the prevalence of adverse neurodevelopmental sequelae remains relatively stable, typically 46% (range: 27-55%). The strongest predictors of outcome are the underlying cause, together with the background electroencephalographic activity. In preterm babies, for whom the outlook tends to be worse as background mortality and disability are high, seizures are frequently associated with serious underlying brain injury and therefore subsequent impairments. When attempting to define the prognosis for a baby with neonatal seizures, we propose a pathway involving history, examination, and careful consideration of all available results (ideally including brain magnetic resonance imaging) and the response to treatment before synthesizing the best estimate of risk to be conveyed to the family. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. 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

  6. Antipsychotic drugs and seizures.

    PubMed

    Remick, R A; Fine, S H

    1979-02-01

    The authors examine the clinical problem of which antipsychotic drug to use when antipsychotics are indicated in patients with a seizuire disorder or who are susceptible to seizures. While definitive answers to this problem are still unknown, guidelines are offered for antipsychotic drug use in this situation, based on the author's understanding of psychotropics and epilepsy.

  7. [Post traumatic partial seizures].

    PubMed

    Carvajal, P; Almárcegui, C; Pablo, M J; Peralta, P; Bernal, M; Valdizán, J R

    Post traumatic epilepsy represents 4% of the prevalence of the disorder and is one of the sequelas which is most difficult to prevent. Risk factors have been described to predict the appearance of seizures. A seven year old boy with a severe head injury was admitted to the Intensive Care Unit. On neuroimaging studies there were multiple foci of contusion, mainly in the left hemisphere, and blood in the III and IV ventricles and frontal horn of the left lateral ventricle. The patient had severe sequelae of head injury with a right spastic hemiplegia and hemiparesia with hypertony of the left side, together with complete blindness of both eyes due to bilateral atrophy of the optic nerve. Serial EEG were done, in which a recording showed alternating periods of hypervoltage grapho elements superimposed on a trace of very low voltage, with continuous activity of low voltage and low frequency. There were no grapho elements with acute morphology. However, the patient had a first partial seizure a year and a half after his head injury. On the EEG an epileptogenic focus was identified in the left hemisphere. Within two years of his head injury he had seven seizures. He had not received prophylactic antiepileptic treatment after the head injury. We report a case of epilepsy secondary to a head injury, in which the first seizure occurred one and a half years after injury. In view of the risk factors, we discuss whether prophylactic anti epileptic treatment might have been beneficial.

  8. Multisystemic Therapy for Child Non-Externalizing Psychological and Health Problems: A Preliminary Review

    ERIC Educational Resources Information Center

    Pane, Heather T.; White, Rachel S.; Nadorff, Michael R.; Grills-Taquechel, Amie; Stanley, Melinda A.

    2013-01-01

    Multisystemic therapy (MST) is effective for decreasing or preventing delinquency and other externalizing behaviors and increasing prosocial or adaptive behaviors. The purpose of this project was to review the literature examining the efficacy of MST for other child psychological and health problems reflecting non-externalizing behaviors,…

  9. An Independent Effectiveness Trial of Multisystemic Therapy with Juvenile Justice Youth

    ERIC Educational Resources Information Center

    Timmons-Mitchell, Jane; Bender, Monica B.; Kishna, Maureen A.; Mitchell, Clare C.

    2006-01-01

    This study examines the effectiveness of an evidence-based practice, multisystemic therapy (MST), conducted in a real-world mental health setting with juvenile justice involved youth and their families. Importantly, this is the first randomized clinical trial of MST with juvenile offenders in the United States conducted without direct oversight by…

  10. Multisystemic Therapy for Child Non-Externalizing Psychological and Health Problems: A Preliminary Review

    ERIC Educational Resources Information Center

    Pane, Heather T.; White, Rachel S.; Nadorff, Michael R.; Grills-Taquechel, Amie; Stanley, Melinda A.

    2013-01-01

    Multisystemic therapy (MST) is effective for decreasing or preventing delinquency and other externalizing behaviors and increasing prosocial or adaptive behaviors. The purpose of this project was to review the literature examining the efficacy of MST for other child psychological and health problems reflecting non-externalizing behaviors,…

  11. 28. VIEW SOUTH FROM SLC3W MST STATION 63. FOREGROUND LEFT: ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    28. VIEW SOUTH FROM SLC-3W MST STATION 63. FOREGROUND LEFT: THEODOLITE SHELTER (BLDG. 786) CENTER LEFT TO RIGHT: GLOBAL POSITIONING SYSTEM AZIMUTH STATION (BLDG. 775), PYROTECHNIC SHED (BLDG. 757), PORTABLE GUARD SHED, METEOROLOGICAL SHED (BLDG. 756), METEOROLOGICAL TOWER. BACKGROUND CENTER TO RIGHT: STORAGE SHED (BLDG. 776), LIQUID OXYGEN APRON, SLC-3E MST, TOP OF SLC-3E FUEL STORAGE TANK. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  12. Comparison of the Intramuscular, Intranasal or Sublingual Routes of Midazolam Administration for the Control of Soman-Induced Seizures

    DTIC Science & Technology

    2008-01-01

    seizures. Indian J Pediatr 2006; 73 :275–8. 17 Wolfe TR, Macfarlane TC. Intranasal midazolam therapy for pediatric status epilepticus . Am J Emerg Med...stopped pharmacologically, rapidly progress to status epilepticus , a state of continuous seizure activity or episodes of seizure activity for greater...than 30 min. with no recovery of con- sciousness between episodes. Status epilepticus itself is considered a medical emergency, and the longer seizures

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

    PubMed Central

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

    2013-01-01

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

  14. Genetics of reflex seizures and epilepsies in humans and animals.

    PubMed

    Italiano, Domenico; Striano, Pasquale; Russo, Emilio; Leo, Antonio; Spina, Edoardo; Zara, Federico; Striano, Salvatore; Gambardella, Antonio; Labate, Angelo; Gasparini, Sara; Lamberti, Marco; De Sarro, Giovambattista; Aguglia, Umberto; Ferlazzo, Edoardo

    2016-03-01

    patients with symptomatic epilepsies but have also been reported in the setting chromosomal disorders or genetically inherited lysosomal storage diseases. The genetic background of reflex seizures and epilepsies is heterogeneous and mostly unknown with no major gene identified in humans. The benefits offered by next-generation sequencing technologies should be merged with increasing information on animal models that represent an useful tool to study the mechanism underlying epileptogenesis. Finally, we expect that genetic studies will lead to a better understanding of the multiple factors involved in the pathophysiology of reflex seizures, and eventually to develop preventive strategies focused on seizure control and therapy optimization. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Multimerization of Drosophila sperm protein Mst77F causes a unique condensed chromatin structure

    PubMed Central

    Kost, Nils; Kaiser, Sophie; Ostwal, Yogesh; Riedel, Dietmar; Stützer, Alexandra; Nikolov, Miroslav; Rathke, Christina; Renkawitz-Pohl, Renate; Fischle, Wolfgang

    2015-01-01

    Despite insights on the cellular level, the molecular details of chromatin reorganization in sperm development, which involves replacement of histone proteins by specialized factors to allow ultra most condensation of the genome, are not well understood. Protamines are dispensable for DNA condensation during Drosophila post-meiotic spermatogenesis. Therefore, we analyzed the interaction of Mst77F, another very basic testis-specific protein with chromatin and DNA as well as studied the molecular consequences of such binding. We show that Mst77F on its own causes severe chromatin and DNA aggregation. An intrinsically unstructured domain in the C-terminus of Mst77F binds DNA via electrostatic interaction. This binding results in structural reorganization of the domain, which induces interaction with an N-terminal region of the protein. Via putative cooperative effects Mst77F is induced to multimerize in this state causing DNA aggregation. In agreement, overexpression of Mst77F results in chromatin aggregation in fly sperm. Based on these findings we postulate that Mst77F is crucial for sperm development by giving rise to a unique condensed chromatin structure. PMID:25735749

  16. Emulating the Visual Receptive Field Properties of MST Neurons with a Template Model of Heading Estimation

    NASA Technical Reports Server (NTRS)

    Perrone, John A.; Stone, Leland S.

    1997-01-01

    We have previously proposed a computational neural-network model by which the complex patterns of retinal image motion generated during locomotion (optic flow) can be processed by specialized detectors acting as templates for specific instances of self-motion. The detectors in this template model respond to global optic flow by sampling image motion over a large portion of the visual field through networks of local motion sensors with properties similar to neurons found in the middle temporal (MT) area of primate extrastriate visual cortex. The model detectors were designed to extract self-translation (heading), self-rotation, as well as the scene layout (relative distances) ahead of a moving observer, and are arranged in cortical-like heading maps to perform this function. Heading estimation from optic flow has been postulated by some to be implemented within the medial superior temporal (MST) area. Others have questioned whether MST neurons can fulfill this role because some of their receptive-field properties appear inconsistent with a role in heading estimation. To resolve this issue, we systematically compared MST single-unit responses with the outputs of model detectors under matched stimulus conditions. We found that the basic physiological properties of MST neurons can be explained by the template model. We conclude that MST neurons are well suited to support heading estimation and that the template model provides an explicit set of testable hypotheses which can guide future exploration of MST and adjacent areas within the primate superior temporal sulcus.

  17. Localized SXR Emission During Electron Bernstein Wave Injection in MST

    NASA Astrophysics Data System (ADS)

    Anderson, Jay; Forest, Cary; Seltzman, Andrew

    2008-11-01

    The electron Bernstein wave has been suggested as a solution to the RFP confinement problem: sustained, off-axis current drive stabilizes the resistive tearing modes which govern thermal transport. A staged experiment to test the feasibility of EBW heating and current drive is underway on MST. Experiments (˜10^5 W) aimed at a demonstration of EBW heating have produced a localized increase in SXR emission. This measured emission is consistent with modeling in its location, energy spectrum and dependence on radial diffusion within the plasma. Preliminary analysis indicates that the emission is strongest in the region where ray tracing predicts maximum deposition of the injected power. The multi-chord SXR camera used is sensitive to 4-7 keV photons which is consistent with Fokker-Plank modeling of EBW injection. The enhanced SXR emission vanishes quickly when radial diffusion in the plasma is high (as indicated by m=0 magnetic activity); this is also consistent with Fokker-Plank modeling. An increase of boron emission (and presumably boron within the plasma) is also observed during EBW injection. This presents an alternative explanation to the enhanced SXR emission; recent efforts have been made to isolate the two effects.

  18. Improvements in SXR and Te Measurements on MST

    NASA Astrophysics Data System (ADS)

    Goetz, J. A.; McGarry, M. B.; Franz, P.; den Hartog, D. J.; Johnson, J.

    2014-10-01

    A diagnostic that uses soft-x-ray (SXR) emission to provide both tomographically reconstructed x-ray emissivity and double-foil electron temperature from either brightness or emissivity has been in use on MST. Analysis of the data from this system has revealed several effects that were not accounted for in past diagnostics. For example, the purity (>99.8%) of the beryllium foils used to block visible light and to select the SXR energy range can produce significant changes in the data by altering the transmission function. In addition, the detailed geometry of the SXR detectors (silicon photodiodes) must be taken into account, including any difference in material composition such as the presence of oxides, front windows and frames, etc., to avoid misinterpretation of the data. All of these effects have been studied and will be presented in this work. Modifications of the diagnostic have been implemented in order to decrease the impact of these features on the measurements and have thus led to improved measurements and a validation of the results from the diagnostic. Time-resolved SXR emissivity and full radial profiles of electron temperature have been analyzed. In particular, high current improved confinement discharges often exhibit enhanced emission from island structures, both rotating and locked. Analysis has been concentrated on the correlation of SXR structures with temperature profiles in locked plasmas. Work supported by USDoE.

  19. 3-D Measurement of Recycling and Radiation in MST

    NASA Astrophysics Data System (ADS)

    Norval, Ryan; Goetz, John; Schmitz, Oliver

    2016-10-01

    The MST reversed-field pinch (RFP) can undergo spontaneous transition to a helical core state, associated with the growth of the innermost resonant magnetic mode. Currently multiple 2-D imaging cameras are in place allowing for nearly full vessel viewing and measurement of recycling and impurities fluxes. The transition from the standard to helical RFP causes an observable change in edge plasma. While in the helical state the plasma wall interaction (PWI) on MSTs poloidal limiter strongly correlates with the helicity of the core mode. PWI on the toroidal limiter overall is reduced, with the remaining PWI sites corresponding the helicity of the core mode, or the locations of diagnostic limiters and the error fields they create. EIRENE, a neutral particle code use for modeling edge plasmas, is used to compute the neutral profiles based on measured recycling fluxes. EIRENE computes the radiative and charge exchange power losses. Comparison is made between the standard and helical RFP plasmas. Bolometer measurements of total radiation are currently in progress to supplement the modeling. This work is supported by the U.S. Department of Energy.

  20. System studies of rf current drive for MST

    SciTech Connect

    Anderson, J. K.; Burke, D. R.; Forest, C. B.; Goetz, J. A.; Hendries, E. R.; Seltzman, A. H.; Thomas, M. A.; Diem, S.; Harvey, R. W.; Kaufman, M. C.

    2011-12-23

    Two rf schemes are being studied on the MST reversed field pinch for their potential in current profile control experiments. MHD modeling has shown that a substantial externally-driven off axis parallel current can improve stability of the dominant core tearing modes. A radially localized axisymmetric population of fast electrons has been observed by SXR emission during LH injection (100kW at 800MHz), and is consistent with CQL3D modeling which predicts a small driven current. Computational work suggests that doubling the input power will statistically improve the LH-induced SXR signal to background ratio, and that about 2MW of injected power (an order of magnitude increase) will drive enough current for stabilization of tearing modes. Additionally, a 1 MW 5.5 GHz electron Bernstein wave (EBW) experiment is under construction, which utilizes a very simple and compact antenna compatible with the demands of the RFP. EBW allows access to electron cyclotron heating and current drive in the overdense plasma. Coupling of the external electromagnetic wave to the EBW has been demonstrated, and initial tests at {approx}100kW power have produced a small, localized xray flux consistent with rf heating and high diffusivity of fast electrons. Computational work is currently underway to answer the very important questions of how much power is required, and what level of electron diffusivity is tolerable, to generate a consequential amount of EBW current.

  1. Febrile and other occasional seizures.

    PubMed

    Bast, T; Carmant, L

    2013-01-01

    Seizures with fever that result from encephalitis or meningitis usually occur late in the course of febrile illness, and are focal and prolonged. Febrile seizures are by far the most common affecting 5% of the population, followed by posttraumatic seizures and those observed in the setting of a toxic, infectious, or metabolic encephalopathy. This chapter reviews the clinical presentation of the three most common forms, due to fever, trauma, and intoxication. Febrile seizures carry no cognitive or mortality risk. Recurrence risk is increased by young age, namely before 1 year of age. Febrile seizures that persist after the age of 6 years are usually part of the syndrome of Generalized epilepsy febrile seizures plus. These febrile seizures have a strong link with epilepsy since non-febrile seizures may occur later in the same patient and in other members of the same family with an autosomal dominant transmission. Complex febrile seizures, i.e., with focal or prolonged manifestations or followed by focal defect, are related to later mesial temporal epilepsy with hippocampal sclerosis; risk factors are seizure duration and brain malformation. Prophylactic treatment is usually not required in febrile seizures. Early onset of complex seizures is the main indication for AED prophylaxis. Early posttraumatic seizures, i.e., within the first week, are often focal and indicate brain trauma: contusion, hematoma, 24 hours amnesia, and depressed skull fracture are major factors of posttraumatic epilepsy. Prophylaxis with antiepileptic drugs is not effective. Various psychotropic drugs, including antiepileptics, may cause seizures. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Distinct EEG seizure patterns reflect different seizure generation mechanisms

    PubMed Central

    Salami, Pariya; Lévesque, Maxime; Gotman, Jean

    2015-01-01

    Low-voltage fast (LVF)- and hypersynchronous (HYP)-seizure onset patterns can be recognized in the EEG of epileptic animals and patients with temporal lobe epilepsy. Ripples (80–200 Hz) and fast ripples (250–500 Hz) have been linked to each pattern, with ripples predominating during LVF seizures and fast ripples predominating during HYP seizures in the rat pilocarpine model. This evidence led us to hypothesize that these two seizure-onset patterns reflect the contribution of neural networks with distinct transmitter signaling characteristics. Here, we tested this hypothesis by analyzing the seizure activity induced with the K+ channel blocker 4-aminopyridine (4AP, 4–5 mg/kg ip), which enhances both glutamatergic and GABAergic transmission, or the GABAA receptor antagonist picrotoxin (3–5 mg/kg ip); rats were implanted with electrodes in the hippocampus, the entorhinal cortex, and the subiculum. We found that LVF onset occurred in 82% of 4AP-induced seizures whereas seizures after picrotoxin were always HYP. In addition, high-frequency oscillation analysis revealed that 4AP-induced LVF seizures were associated with higher ripple rates compared with fast ripples (P < 0.05), whereas picrotoxin-induced seizures contained higher rates of fast ripples compared with ripples (P < 0.05). These results support the hypothesis that two distinct patterns of seizure onset result from different pathophysiological mechanisms. PMID:25652916

  3. Febrile seizures and genetic epilepsy with febrile seizures plus (GEFS+).

    PubMed

    Camfield, Peter; Camfield, Carol

    2015-06-01

    To review the literature about febrile seizures and GEFS plus with special emphasis on management and outcome. Selected literature review. Febrile seizures are the most common convulsive event in humans, occurring in 2-6% of the population. The aetiology is complex with strong evidence for a heterogeneous genetic predisposition interacting with fever of any cause, with certain viral infections having a greater effect. A large amount of literature has established that febrile seizures have no long-term consequences on cognition or behaviour. Unfortunately, about 40% of children with a first febrile seizure will have a recurrence. The strongest predictor of recurrence is age <14-16 months at the time of the first febrile seizure. Epilepsy follows febrile seizures in ∼3% cases, with the concepts of simple and complex febrile seizures providing relatively weak prediction. Very prolonged febrile seizures may lead to mesial temporal sclerosis and temporal lobe epilepsy although the degree of risk remains uncertain. Investigations beyond establishing the cause of the provoking fever are nearly always unnecessary. Treatment is mainly reassurance and there is some evidence that parents eventually "come to grips" with the fear that their children are dying during a febrile seizure. Antipyretic medications are remarkably ineffective to prevent recurrences. Daily and intermittent prophylactic medications are ineffective or have unacceptable side effects or risks. "Rescue" benzodiazepines may prevent prolonged recurrences for selected patients with a first prolonged febrile seizure although this has not been proven. Genetic epilepsy with febrile seizures plus (GEFS+) is a complex autosomal dominant disorder usually caused by mutations in SCN1A (a voltage-gated sodium channel). One third of patients have febrile seizures only; two thirds have a variety of epilepsy syndromes, both focal and generalized. Febrile seizures may distress parents but rarely have any long

  4. Temporal lobe epilepsy: where do the seizures really begin?

    PubMed

    Bertram, Edward H

    2009-01-01

    Defining precisely the site of seizure onset has important implications for our understanding of the pathophysiology of temporal lobe epilepsy, as well as for the surgical treatment of the disorder. Removal of the limbic areas of the medial temporal lobe has led to a high rate of seizure control, but the relatively large number of patients for whom seizure control is incomplete, as well as the low rate of surgical cure, suggests that the focus extends beyond the usual limits of surgical resection. Reevaluation of the extent of the pathology, as well as new data from animal models, suggests that the seizure focus extends, at least in some cases, beyond the hippocampus and amygdala, which are usually removed at the time of surgery. In this review, we examine current information about the pathology and physiology of mesial temporal lobe epilepsy syndrome, with special emphasis on the distribution of the changes and patterns of seizure onset. We then propose a hypothesis for the nature of the seizure focus in this disorder and discuss its clinical implications, with the ultimate goal of improving surgical outcomes and developing nonsurgical therapies that may improve seizure control.

  5. Temporal Lobe Epilepsy: Where Do the Seizures Really Begin?

    PubMed Central

    Bertram, Edward H.

    2010-01-01

    Defining precisely the site of seizure onset has important implication for our understanding of the pathophysiology of temporal lobe epilepsy as well as for the surgical treatment of the disorder. Removal of the limbic areas of the medial temporal lobe has led to a high rate of seizure control, but the relatively large number of patients for whom seizure control is incomplete as well as the low rate of surgical cure suggest that the focus extends beyond the usual limits of surgical resection. A reevaluation of the extent of the pathology as well as new data from animal models suggest that the seizure focus extends, at least in some cases, beyond the hippocampus and amygdala that are usually removed at the time of surgery. In this review we will examine current information about the pathology and physiology of the mesial temporal lobe epilepsy syndrome, with a special emphasis on the distribution of the changes and the patterns of seizure onset. We will then propose a hypothesis for the nature of the seizure focus in this disorder and discuss its clinical implications, with the ultimate goal of improving surgical outcomes and developing nonsurgical therapies that may improve seizure control. PMID:18848643

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

    PubMed Central

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

    2015-01-01

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

  7. Development of spontaneous recurrent seizures after kainate-induced status epilepticus

    PubMed Central

    Williams, Philip A.; White, Andrew M.; Clark, Suzanne; Ferraro, Damien J.; Swiercz, Waldemar; Staley, Kevin J.; Dudek, F. Edward

    2009-01-01

    Acquired epilepsy (i.e., after an insult to the brain) is often considered to be a progressive disorder, and the nature of this hypothetical progression remains controversial. Antiepileptic drug treatment necessarily confounds analyses of progressive changes in human patients with acquired epilepsy. Here we describe experiments testing the hypothesis that development of acquired epilepsy begins as a continuous process of increased seizure frequency (i.e., proportional to probability of a spontaneous seizure) that ultimately plateaus. Using nearly continuous surface cortical and bilateral hippocampal recordings with radiotelemetry and semi-automated seizure detection, the frequency of electrographically recorded seizures (both convulsive and non-convulsive) was analyzed quantitatively for about 100 days after kainate-induced status epilepticus in adult rats. The frequency of spontaneous recurrent seizures was not a step-function of time (as implied by the “latent period”); rather, seizure frequency increased as a sigmoid function of time. The distribution of inter-seizure intervals was non-random, suggesting that seizure clusters (i.e., short inter-seizure intervals) obscured the early stages of progression, and may have contributed to the increase in seizure frequency. These data suggest that (1) the latent period is the first of many long inter-seizure intervals and a poor measure of the timeframe of epileptogenesis; (2) epileptogenesis is a continuous process that extends much beyond the first spontaneous recurrent seizure; (3) uneven seizure clustering contributes to the variability in occurrence of epileptic seizures; and (4) the window for anti-epileptogenic therapies aimed at suppressing acquired epilepsy probably extends well past the first clinical seizure. PMID:19228963

  8. Ion dynamics during seizures

    PubMed Central

    Raimondo, Joseph V.; Burman, Richard J.; Katz, Arieh A.; Akerman, Colin J.

    2015-01-01

    Changes in membrane voltage brought about by ion fluxes through voltage and transmitter-gated channels represent the basis of neural activity. As such, electrochemical gradients across the membrane determine the direction and driving force for the flow of ions and are therefore crucial in setting the properties of synaptic transmission and signal propagation. Ion concentration gradients are established by a variety of mechanisms, including specialized transporter proteins. However, transmembrane gradients can be affected by ionic fluxes through channels during periods of elevated neural activity, which in turn are predicted to influence the properties of on-going synaptic transmission. Such activity-induced changes to ion concentration gradients are a feature of both physiological and pathological neural processes. An epileptic seizure is an example of severely perturbed neural activity, which is accompanied by pronounced changes in intracellular and extracellular ion concentrations. Appreciating the factors that contribute to these ion dynamics is critical if we are to understand how a seizure event evolves and is sustained and terminated by neural tissue. Indeed, this issue is of significant clinical importance as status epilepticus—a type of seizure that does not stop of its own accord—is a life-threatening medical emergency. In this review we explore how the transmembrane concentration gradient of the six major ions (K+, Na+, Cl−, Ca2+, H+and HCO3−) is altered during an epileptic seizure. We will first examine each ion individually, before describing how multiple interacting mechanisms between ions might contribute to concentration changes and whether these act to prolong or terminate epileptic activity. In doing so, we will consider how the availability of experimental techniques has both advanced and restricted our ability to study these phenomena. PMID:26539081

  9. [Epileptic seizures in childhood: from seizure type to diagnosis].

    PubMed

    Milh, M; Ticus, I; Villeneuve, N; Hugonencq, C; Mancini, J; Chabrol, B

    2008-02-01

    Epileptic seizures can be difficult to recognize in infancy and childhood because the semeiology can be misleading. Already, in the acute phase, precise assessment of the seizure is required, with active questioning about circumstances of occurrence, clinical manifestations and postictal symptoms. Laboratory tests and toxicologic screening should only be performed according to the circumstances and clinical examination in order to distinguish between symptomatic seizure and epilepsy at the beginning. Epilepsy consists in repetition of several unprovoked epileptic seizure. Assessment of the age of onset, type of seizures, interictal EEG and the neuropsychological profile are instrumental for both the diagnosis of epileptic syndrome and the choice of the right treatment. Epileptic seizures cause distress to parents and the fear they experience of death must always be taken into account.

  10. Pediatric-onset gelastic seizures: clinical data and outcome.

    PubMed

    Shahar, Eli; Kramer, Uri; Mahajnah, Muhammad; Lerman-Sagie, Tallie; Goez, Rachel; Gross, Varda; Kutai, Miriam; Genizi, Jacob

    2007-07-01

    Gelastic seizures are an extremely rare form of epilepsy defined as automatic bouts of laughter without mirth commonly associated with a hypothalamic hamartoma. The objective was to survey all Israeli children found to develop recurrent gelastic seizures and report presenting symptoms, electroencephalographic and radiologic data, and response to either antiepileptic drugs or surgery. Ten children who developed gelastic seizures at the age of 1 week to 6.5 years (mean, 25 months) at a frequency from 3 bouts per week to >10 prolonged bouts per day were followed for a period of 1.3-12 years (mean, 6 years). Seven cases were defined as symptomatic: cortical magnetic resonance imaging revealed a hypothalamic hamartoma in four patients and cortical abnormalities in three others. Seizure control was achieved in four patients, including a neonate with status gelasticus and hypothalamic hamartoma, and partial control in one more. Five children remained resistant to polytherapy, including three with hypothalamic hamartoma even after two of them underwent hemartoma excision. Thus, children with gelastic seizures may respond relatively well to drug therapy. Four of the 10 patients became seizure free with drug therapy; in three intractable symptomatic cases, surgery was tried but failed in two of the three.

  11. Spontaneous resolution of intractable epileptic seizures following HHV-7 infection.

    PubMed

    Yamamoto, Hitoshi; Kamiyama, Noriko; Murakami, Hiroshi; Miyamoto, Yusaku; Fukuda, Miho

    2007-04-01

    We report a three-year-old female with intractable epilepsy post West syndrome whose seizures disappeared following an acute viral infection, without changes in anti-epileptic therapy. The female infant was born at term to a healthy mother after an uneventful pregnancy and delivery. At the age of five months, she developed intractable brief tonic spasms which had a series of infantile spasms, and an electroencephalogram indicated hypsarrhythmia. She was diagnosed with West syndrome. The seizures were uncontrollable with conventional therapy, including ACTH, vigabatrin, sodium valproate, clonazepam, zonisamide, and ketogenic diet. Daily multiple generalized tonic seizures and brief tonic spasms were observed before an episode of viral infection. At the age of three years, the intractable seizures disappeared after a febrile rash illness due to human herpesvirus 7 (HHV-7) infection, without changes in anti-epileptic drugs. The disappearance of intractable epileptic seizures following acute viral infections might be related to the inflammatory or immunologic processes associated with viral infections. This is the first documented case of spontaneous remission of intractable epileptic seizures following HHV-7 infection.

  12. Nonepileptic Seizures: An Updated Review

    PubMed Central

    Perez, David L.; LaFrance, W. Curt

    2016-01-01

    Psychogenic nonepileptic seizures are a Functional Neurological Disorder/ Conversion Disorder subtype, which are neurobehavioral conditions at the interface of Neurology and Psychiatry. Significant advancements over the past decade have been made in the diagnosis, management and neurobiological understanding of PNES. This article reviews published PNES research focusing on semiologic features that distinguish PNES from epileptic seizures, consensus diagnostic criteria, the intersection of PNES and other comorbidities, neurobiological studies, evidence-based treatment interventions and outcome studies. Epidemiology and health care utilization studies highlight a continued unmet medical need in the comprehensive care of PNES. Consensus guidelines for diagnostic certainty are based on clinical history, semiology of witnessed typical event(s), and EEG findings. While certain semiologic features may aid the diagnosis of PNES, the gold standard remains capturing a typical event on video electroencephalography (EEG) showing the absence of epileptiform activity with history and semiology consistent with PNES. Medical-neurologic and psychiatric comorbidities are prevalent in PNES and should be assessed in diagnostic evaluations, and integrated into treatment interventions and prognostic considerations. Several studies, including a pilot multicenter, randomized clinical trial, have now demonstrated that a cognitive behavioral therapy informed psychotherapy is an efficacious treatment for PNES, and additional efforts are necessary to evaluate the utility of pharmacologic and other psychotherapy treatments. Neuroimaging studies, while requiring replication, suggest that PNES may occur in the context of alterations within and across sensorimotor, emotion regulation/processing, cognitive control and multimodal integration brain systems. Future research could investigate similarities and differences between PNES and other somatic symptom disorders. PMID:26996600

  13. Evaluation of the pentylenetetrazole seizure threshold test in epileptic mice as surrogate model for drug testing against pharmacoresistant seizures.

    PubMed

    Töllner, Kathrin; Twele, Friederike; Löscher, Wolfgang

    2016-04-01

    Resistance to antiepileptic drugs (AEDs) is a major problem in epilepsy therapy, so that development of more effective AEDs is an unmet clinical need. Several rat and mouse models of epilepsy with spontaneous difficult-to-treat seizures exist, but because testing of antiseizure drug efficacy is extremely laborious in such models, they are only rarely used in the development of novel AEDs. Recently, the use of acute seizure tests in epileptic rats or mice has been proposed as a novel strategy for evaluating novel AEDs for increased antiseizure efficacy. In the present study, we compared the effects of five AEDs (valproate, phenobarbital, diazepam, lamotrigine, levetiracetam) on the pentylenetetrazole (PTZ) seizure threshold in mice that were made epileptic by pilocarpine. Experiments were started 6 weeks after a pilocarpine-induced status epilepticus. At this time, control seizure threshold was significantly lower in epileptic than in nonepileptic animals. Unexpectedly, only one AED (valproate) was less effective to increase seizure threshold in epileptic vs. nonepileptic mice, and this difference was restricted to doses of 200 and 300 mg/kg, whereas the difference disappeared at 400mg/kg. All other AEDs exerted similar seizure threshold increases in epileptic and nonepileptic mice. Thus, induction of acute seizures with PTZ in mice pretreated with pilocarpine does not provide an effective and valuable surrogate method to screen drugs for antiseizure efficacy in a model of difficult-to-treat chronic epilepsy as previously suggested from experiments with this approach in rats. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Localization of pediatric seizure semiology.

    PubMed

    Vendrame, Martina; Zarowski, Marcin; Alexopoulos, Andreas V; Wyllie, Elaine; Kothare, Sanjeev V; Loddenkemper, Tobias

    2011-10-01

    The aim of this study was to evaluate the relationship between semiology of seizures in children and adolescents to the corresponding EEG localization. Charts of 225 consecutive pediatric epilepsy patients undergoing Video-EEG monitoring (VEM) over 2 years were reviewed. Seizure semiology recorded during VEM was classified according to ILAE seizure semiology terminology and EEG localization, and analyzed based on onset as defined by the EEG data (generalized, frontal, temporal, parietal, occipital or multilobar). A total of 1008 seizures were analyzed in 225 children (mean age 8.5 years, range 0-20), with 50% boys. Auras and seizures with automatisms arose predominantly from the temporal lobes (p<0.001). Tonic, clonic and tonic-clonic seizures had most commonly generalized onset (p<0.001). Hypomotor seizures were most frequently seen from the frontal lobes (p<0.001). Hypermotor seizures had most commonly temporal lobe or multiple lobe onset (p<0.001 and p<0.05 respectively). Atonic, myoclonic seizures and epileptic spasms had almost exclusively a generalized onset (p<0.001). Different seizure semiologies relate to specific brain regions, with overlap between focal and generalized semiological seizure types, as identified electrographically. Semiology of seizures can provide important information for epilepsy localization, and should not be overlooked, especially in patients undergoing pre-surgical evaluation. Separation of clinical seizure description and EEG findings may be useful, in particular when only incomplete information is available. i.e. during the first office visit. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  15. 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. Copyright © 2013 Wiley Periodicals, Inc.

  16. Change of seizure frequency in pregnant epileptic women.

    PubMed Central

    Schmidt, D; Canger, R; Avanzini, G; Battino, D; Cusi, C; Beck-Mannagetta, G; Koch, S; Rating, D; Janz, D

    1983-01-01

    The effect of pregnancy on seizure frequency was monitored prospectively in 136 pregnancies of 122 epileptic women. Pregnancy did not influence the seizure frequency in 68 pregnancies (50%). In 50 pregnancies (37%) the number of seizures increased during pregnancy or puerperium. The seizure frequency decreased in 18 pregnancies (13%). In 34 out of 50 pregnancies (68%) the increase was associated with non-compliance with the drug regimen or sleep deprivation. In seven out of 18 pregnancies (39%) improvement was related to correction of non-compliance or sleep deprivation during the pregestational nine months. Insufficiently low plasma concentrations of antiepileptic drugs were found in 47% of the women with uncontrolled epilepsy during pregnancy. The course of epilepsy during pregnancy is primarily influenced by non-compliance, sleep deprivation during pregnancy, and inadequate therapy before and during pregnancy. With good medical attention pregnancy itself seems to have only a minimal influence on the course of epilepsy. PMID:6411866

  17. Dissociative seizures--a critical review and perspective.

    PubMed

    Schmutz, Matthias

    2013-12-01

    Dissociative seizures are commonly recognized as both a challenging and a poorly understood condition. Though research and publication activity is high, advances in knowledge and insight seem only moderate in recent years. This review focuses on some relevant problematic issues, which might account for a still unsatisfactory research state. A general tendency to deal with dissociative seizures as an assumed disorder in its own nosological right and not as a sole symptom of an underlying psychiatric disorder is most likely one of the major roots of the problem. Unfavorable impacts of this confusion pertaining to clinical management, therapy, and outcome of dissociative seizures are discussed. An alternative point of view, based on the immanent psychiatric and psychodynamic roots of dissociative seizures, is considered. © 2013.

  18. MHD simulation of RF current drive in MST

    NASA Astrophysics Data System (ADS)

    Hendries, E. R.; Anderson, J. K.; Diem, S.; Forest, C. B.; Harvey, R. W.; Reusch, J. A.; Seltzman, A. H.; Sovinec, C. R.

    2014-02-01

    Auxiliary heating and current drive using RF waves such as the electron Bernstein wave (EBW) promises to advance the performance of the reversed field pinch (RFP). In previous computational work [1], a hypothetical edge-localized current drive is shown to suppress the tearing activity which governs the macroscopic transport properties of the RFP. The ideal conditions for tearing stabilization include a reduced toroidal induction, and precise width and radial position of the Gaussian-shaped external current drive. In support of the EBW experiment on the Madison Symmetric Torus, an integrated modeling scheme now incorporates ray tracing and Fokker-Plank predictions of auxiliary current into single fluid MHD. Simulations at low Lundquist number (S ˜ 104) generally agree with the previous work; significantly more burdensome simulations at MST-like Lundquist number (S ˜ 3×106) show unexpected results. The effect on nonlinearly saturated current profile by a particular RF-driven external force decreases in magnitude and widens considerably as the Lundquist number increases toward experimental values. Simulations reproduce the periodic current profile relaxation events observed in experiment (sawteeth) in the absence of current profile control. Reduction of the tearing mode amplitudes is still observable; however, reduction is limited to periods between the large bursts of magnetic activity at each sawtooth. The sawtoothing pattern persists with up to 10 MW of externally applied RF power. Periods with prolonged low tearing amplitude are predicted with a combination of external current drive and a reduced toroidal loop voltage, consistent with previous conclusions. Finally, the resistivity profile is observed to have a strong effect on the optimal externally driven current profile for mode stabilization.

  19. MHD simulation of RF current drive in MST

    SciTech Connect

    Hendries, E. R.; Anderson, J. K.; Forest, C. B.; Reusch, J. A.; Seltzman, A. H.; Sovinec, C. R.; Diem, S.; Harvey, R. W.

    2014-02-12

    Auxiliary heating and current drive using RF waves such as the electron Bernstein wave (EBW) promises to advance the performance of the reversed field pinch (RFP). In previous computational work [1], a hypothetical edge-localized current drive is shown to suppress the tearing activity which governs the macroscopic transport properties of the RFP. The ideal conditions for tearing stabilization include a reduced toroidal induction, and precise width and radial position of the Gaussian-shaped external current drive. In support of the EBW experiment on the Madison Symmetric Torus, an integrated modeling scheme now incorporates ray tracing and Fokker-Plank predictions of auxiliary current into single fluid MHD. Simulations at low Lundquist number (S ∼ 10{sup 4}) generally agree with the previous work; significantly more burdensome simulations at MST-like Lundquist number (S ∼ 3×10{sup 6}) show unexpected results. The effect on nonlinearly saturated current profile by a particular RF-driven external force decreases in magnitude and widens considerably as the Lundquist number increases toward experimental values. Simulations reproduce the periodic current profile relaxation events observed in experiment (sawteeth) in the absence of current profile control. Reduction of the tearing mode amplitudes is still observable; however, reduction is limited to periods between the large bursts of magnetic activity at each sawtooth. The sawtoothing pattern persists with up to 10 MW of externally applied RF power. Periods with prolonged low tearing amplitude are predicted with a combination of external current drive and a reduced toroidal loop voltage, consistent with previous conclusions. Finally, the resistivity profile is observed to have a strong effect on the optimal externally driven current profile for mode stabilization.

  20. Seizures in Preterm Neonates: A Multicenter Observational Cohort Study.

    PubMed

    Glass, Hannah C; Shellhaas, Renée A; Tsuchida, Tammy N; Chang, Taeun; Wusthoff, Courtney J; Chu, Catherine J; Cilio, M Roberta; Bonifacio, Sonia L; Massey, Shavonne L; Abend, Nicholas S; Soul, Janet S

    2017-07-01

    The purpose of this study was to characterize seizures among preterm neonates enrolled in the Neonatal Seizure Registry, a prospective cohort of consecutive neonates with seizures at seven pediatric centers that follow the American Clinical Neurophysiology Society's neonatal electroencephalography monitoring guideline. Of 611 enrolled neonates with seizures, 92 (15%) were born preterm. Seizure characteristics were evaluated by gestational age at birth for extremely preterm (<28 weeks, N = 18), very preterm (28 to <32 weeks, N = 18), and moderate to late preterm (32 to <37 weeks, N = 56) and compared with term neonates. Hypoxic-ischemic encephalopathy (33%) and intracranial hemorrhage (27%) accounted for the etiology in more than half of preterm neonates. Hypothermia therapy was utilized in 15 moderate to late preterm subjects with encephalopathy. The presence of subclinical seizures, monotherapy treatment failure, and distribution of seizure burden (including status epilepticus) was similar in preterm and term neonates. However, exclusively subclinical seizures occurred more often in preterm than term neonates (24% vs 14%). Phenobarbital was the most common initial medication for all gestational age groups, and failure to respond to an initial loading dose was 63% in both preterm and term neonates. Mortality was similar among the three preterm gestational age groups; however, preterm mortality was more than twice that of term infants (35% vs 15%). Subclinical seizures were more common and mortality was higher for preterm than term neonates. These data underscore the importance of electroencephalographic monitoring and the potential for improved management in preterm neonates. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. A Randomized Clinical Trial of Multisystemic Therapy with Juvenile Sexual Offenders: Effects on Youth Social Ecology and Criminal Activity

    ERIC Educational Resources Information Center

    Borduin, Charles M.; Schaeffer, Cindy M.; Heiblum, Naamith

    2009-01-01

    A randomized clinical trial evaluated the efficacy of multisystemic therapy (MST) versus usual community services (UCS) for 48 juvenile sexual offenders at high risk of committing additional serious crimes. Results from multiagent assessment batteries conducted before and after treatment showed that MST was more effective than UCS in improving key…

  2. MST3 Kinase Phosphorylates TAO1/2 to Enable Myosin Va Function in Promoting Spine Synapse Development

    PubMed Central

    Ultanir, Sila K.; Yadav, Smita; Hertz, Nicholas T.; Oses-Prieto, Juan A.; Claxton, Suzanne; Burlingame, Alma L.; Shokat, Kevan M.; Jan, Lily Y.; Jan, Yuh-Nung

    2014-01-01

    Summary Mammalian Sterile 20 (Ste20)-like kinase 3 (MST3) is a ubiquitously expressed kinase capable of enhancing axon outgrowth. Whether and how MST3 kinase signaling might regulate development of dendritic filopodia and spine synapses is unknown. Through shRNA-mediated depletion of MST3 and kinase-dead MST3 expression in developing hippocampal cultures, we found that MST3 is necessary for proper filopodia, dendritic spine, and excitatory synapse development. Knockdown of MST3 in layer 2/3 pyramidal neurons via in utero electroporation also reduced spine density in vivo. Using chemical genetics, we discovered thirteen candidate MST3 substrates and identified the phosphorylation sites. Among the identified MST3 substrates, TAO kinases regulate dendritic filopodia and spine development, similar to MST3. Furthermore, using stable isotope labeling by amino acids in culture (SILAC), we show that phosphorylated TAO1/2 associates with Myosin Va and is necessary for its dendritic localization, thus revealing a mechanism for excitatory synapse development in the mammalian CNS. PMID:25456499

  3. MST3 kinase phosphorylates TAO1/2 to enable Myosin Va function in promoting spine synapse development.

    PubMed

    Ultanir, Sila K; Yadav, Smita; Hertz, Nicholas T; Oses-Prieto, Juan A; Claxton, Suzanne; Burlingame, Alma L; Shokat, Kevan M; Jan, Lily Y; Jan, Yuh-Nung

    2014-12-03

    Mammalian Sterile 20 (Ste20)-like kinase 3 (MST3) is a ubiquitously expressed kinase capable of enhancing axon outgrowth. Whether and how MST3 kinase signaling might regulate development of dendritic filopodia and spine synapses is unknown. Through shRNA-mediated depletion of MST3 and kinase-dead MST3 expression in developing hippocampal cultures, we found that MST3 is necessary for proper filopodia, dendritic spine, and excitatory synapse development. Knockdown of MST3 in layer 2/3 pyramidal neurons via in utero electroporation also reduced spine density in vivo. Using chemical genetics, we discovered thirteen candidate MST3 substrates and identified the phosphorylation sites. Among the identified MST3 substrates, TAO kinases regulate dendritic filopodia and spine development, similar to MST3. Furthermore, using stable isotope labeling by amino acids in culture (SILAC), we show that phosphorylated TAO1/2 associates with Myosin Va and is necessary for its dendritic localization, thus revealing a mechanism for excitatory synapse development in the mammalian CNS.

  4. 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.

  5. [Simple febrile seizure, complex seizure, generalized epilepsy with febrile seizure plus, FIRES and new syndromes].

    PubMed

    Moreno de Flagge, Noris

    2013-01-01

    Febrile seizures are the most common seizures in childhood. They have been observed in 2-5% of children before the age of 5, but in some populations this figure may increase to 15%. It is a common cause of pediatric hospital admissions and cause of anxiety for parents. Febrile seizures could be the first manifestation of epilepsy. About 13% of epileptic patients have a history of febrile seizure, and 30% have had recurrent febrile seizures. Their phenotypic characteristics allow, in the majority of cases, a classification of the seizure, an elaboration of a prognosis and to assume a specific therapeutic attitude. It is possible to describe a spectrum according to their severity, from the benign simple seizure to the more complex, febrile seizure plus, Dravet'syndrome, and FIRES. During the past decade, molecular genetic studies have contributed to the identification of genetic factors involved in febrile seizure and related disorders, making the necessity of a careful follow up of these patients in order to detect risk factors earlier. We have reviewed the medical literature to update current knowledge of febrile seizures, their prognosis and their relation to new epileptic syndromes.

  6. The international implementation of multisystemic therapy.

    PubMed

    Schoenwald, Sonja K; Heiblum, Naamith; Saldana, Lisa; Henggeler, Scott W

    2008-06-01

    The purpose of this article is to consider, through the lenses of theory and research on technology transfer and the adoption and implementation of innovation, the international transport of evidence-based psychosocial treatments for youth, using Multisystemic Therapy (MST) as an example. MST is a well-validated family and community-based approach originally developed in the United States to treat serious juvenile offenders. This article describes challenges to MST transport internationally by virtue of the political, legal, economic, and cultural contexts in different nations. Modifications used to address these challenges and facilitate the international implementation of MST are described and pertain to pre-implementation processes, clinical staff, training materials and procedures, and clinical service delivery.

  7. Seizures Following Traumatic Brain Injury in Childhood.

    ERIC Educational Resources Information Center

    Williams, Dennis

    This guide provides information on seizures in students with traumatic brain injury (TBI) and offers guidelines for classroom management. First, a classification system for seizures is presented with specific types of seizures explained. Post-traumatic seizures are specifically addressed as is the importance of seizure prevention when possible.…

  8. Termination of seizure clusters is related to the duration of focal seizures.

    PubMed

    Ferastraoaru, Victor; Schulze-Bonhage, Andreas; Lipton, Richard B; Dümpelmann, Matthias; Legatt, Alan D; Blumberg, Julie; Haut, Sheryl R

    2016-06-01

    Clustered seizures are characterized by shorter than usual interseizure intervals and pose increased morbidity risk. This study examines the characteristics of seizures that cluster, with special attention to the final seizure in a cluster. This is a retrospective analysis of long-term inpatient monitoring data from the EPILEPSIAE project. Patients underwent presurgical evaluation from 2002 to 2009. Seizure clusters were defined by the occurrence of at least two consecutive seizures with interseizure intervals of <4 h. Other definitions of seizure clustering were examined in a sensitivity analysis. Seizures were classified into three contextually defined groups: isolated seizures (not meeting clustering criteria), terminal seizure (last seizure in a cluster), and intracluster seizures (any other seizures within a cluster). Seizure characteristics were compared among the three groups in terms of duration, type (focal seizures remaining restricted to one hemisphere vs. evolving bilaterally), seizure origin, and localization concordance among pairs of consecutive seizures. Among 92 subjects, 77 (83%) had at least one seizure cluster. The intracluster seizures were significantly shorter than the last seizure in a cluster (p = 0.011), whereas the last seizure in a cluster resembled the isolated seizures in terms of duration. Although focal only (unilateral), seizures were shorter than seizures that evolved bilaterally and there was no correlation between the seizure type and the seizure position in relation to a cluster (p = 0.762). Frontal and temporal lobe seizures were more likely to cluster compared with other localizations (p = 0.009). Seizure pairs that are part of a cluster were more likely to have a concordant origin than were isolated seizures. Results were similar for the 2 h definition of clustering, but not for the 8 h definition of clustering. We demonstrated that intracluster seizures are short relative to isolated seizures and terminal seizures. Frontal

  9. Central nervous system herpes simplex virus infection in afebrile children with seizures.

    PubMed

    Majumdar, Indrajit; Hartley-McAndrew, Michelle E; Weinstock, Arie L

    2012-04-01

    Central nervous system herpes simplex virus infection is suspected in patients presenting with acute-onset seizures and lethargy. The potential neurologic sequelae from untreated herpes infection can prompt empirical acyclovir therapy, even in afebrile subjects. The objectives of this study were to determine the frequency of central nervous system herpes simplex virus infection in children presenting with afebrile seizures and to assess the need for empirical acyclovir therapy. Clinical and laboratory data of children with acute-onset afebrile seizures and children with central nervous system herpes simplex virus infection were compared. Polymerase chain reaction and viral cultures of the cerebrospinal fluid for herpes simplex virus infection were negative in all subjects with afebrile seizures; 32.7% of these subjects were empirically treated with acyclovir. In conclusion, central nervous system herpes simplex virus infection is uncommon in children presenting with afebrile seizures, and acyclovir therapy is rarely necessary in subjects with normal neurologic examination and cerebrospinal fluid analysis.

  10. DECONTAMINATION FACTORS AND FILTRATION FLUX IMPACT TO ARP AT REDUCED MST CONCENTRATION

    SciTech Connect

    Hobbs, D.

    2012-06-27

    Tank Farm and Closure Engineering is evaluating changes to the Actinide Removal Process facility operations to decrease the MST concentration from 0.4 g/L to 0.2 g/L and the contact time from 12 hours to between 6 and 8 hours. For this evaluation, SRNL reviewed previous datasets investigating the performance of MST at 0.2 g/L in salt solutions ranging from 4.5 to 7.5 M in sodium concentration. In general, reducing the MST concentration from 0.4 to 0.2 g/L and increasing the ionic strength from 4.5 to 7.5 M in sodium concentration will decrease the measured decontamination factors for plutonium, neptunium, uranium and strontium. The decontamination factors as well as single standard deviation values for each sorbate are reported. These values are applicable within the sorbate and sodium concentrations used in the experimental measurements. Decreasing the MST concentration in the ARP from 0.4 g/L to 0.2 g/L will produce an increase in the filter flux, and could lead to longer operating times between filter cleaning. The increase in flux is a function of a number of operating parameters, and is difficult to quantify. However, it is estimated that the reduction in MST could result in a reduction of filtration time of up to 20%.

  11. Neurons in cortical area MST remap the memory trace of visual motion across saccadic eye movements.

    PubMed

    Inaba, Naoko; Kawano, Kenji

    2014-05-27

    Perception of a stable visual world despite eye motion requires integration of visual information across saccadic eye movements. To investigate how the visual system deals with localization of moving visual stimuli across saccades, we observed spatiotemporal changes of receptive fields (RFs) of motion-sensitive neurons across periods of saccades in the middle temporal (MT) and medial superior temporal (MST) areas. We found that the location of the RFs moved with shifts of eye position due to saccades, indicating that motion-sensitive neurons in both areas have retinotopic RFs across saccades. Different characteristic responses emerged when the moving visual stimulus was turned off before the saccades. For MT neurons, virtually no response was observed after the saccade, suggesting that the responses of these neurons simply reflect the reafferent visual information. In contrast, most MST neurons increased their firing rates when a saccade brought the location of the visual stimulus into their RFs, where the visual stimulus itself no longer existed. These findings suggest that the responses of such MST neurons after saccades were evoked by a memory of the stimulus that had preexisted in the postsaccadic RFs ("memory remapping"). A delayed-saccade paradigm further revealed that memory remapping in MST was linked to the saccade itself, rather than to a shift in attention. Thus, the visual motion information across saccades was integrated in spatiotopic coordinates and represented in the activity of MST neurons. This is likely to contribute to the perception of a stable visual world in the presence of eye movements.

  12. Extrastriate Area MST and Parietal Area VIP Similarly Represent Forward Headings

    PubMed Central

    Maciokas, James B.

    2010-01-01

    Many studies have documented the involvement of medial superior temporal extrastriate area (MST) in the perception of heading based on optic flow information. Furthermore, both heading perception and the responses of MST neurons are relatively stable in the presence of eye movements that distort the retinal flow information on which perception is based. Area VIP in the posterior parietal cortex also contains a robust representation of optic flow cues for heading. However, the studies in the two areas were frequently conducted using different stimuli, making quantitative comparison difficult. To remedy this, we studied MST using a family of random dot heading stimuli that we have previously used in the study of VIP. These stimuli simulate observer translation through a three-dimensional cloud of points, and a range of forward headings was presented both with and without horizontal smooth pursuit eye movements. We found that MST neurons, like VIP neurons, respond robustly to these stimuli and partially compensate for the presence of pursuit. Quantitative comparison of the responses revealed no substantial difference between the heading responses of MST and VIP neurons or in their degree of pursuit tolerance. PMID:20427618

  13. Structural insights into the activation of MST3 by MO25

    PubMed Central

    Mehellou, Youcef; Alessi, Dario R.; Macartney, Thomas J.; Szklarz, Marta; Knapp, Stefan; Elkins, Jonathan M.

    2013-01-01

    The MO25 scaffolding protein operates as critical regulator of a number of STE20 family protein kinases (e.g. MST and SPAK isoforms) as well as pseudokinases (e.g. STRAD isoforms that play a critical role in activating the LKB1 tumour suppressor). To better understand how MO25 interacts and stimulates the activity of STE20 protein kinases, we determined the crystal structure of MST3 catalytic domain (residues 19–289) in complex with full length MO25β. The structure reveals an intricate web of interactions between MST3 and MO25β that function to stabilise the kinase domain in a closed, active, conformation even in the absence of ATP or an ATP-mimetic inhibitor. The binding mode of MO25β is reminiscent of the mechanism by which MO25α interacts with the pseudokinase STRADα. In particular we identified interface residues Tyr223 of MO25β and Glu58 and Ile71 of MST3 that when mutated prevent activation of MST3 by MO25β. These data provide molecular understanding of the mechanism by which MO25 isoforms regulates the activity of STE20 family protein kinases. PMID:23296203

  14. 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…

  15. 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…

  16. 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…

  17. Program of the Antarctic Syowa MST/IS radar (PANSY)

    NASA Astrophysics Data System (ADS)

    Sato, Kaoru; Tsutsumi, Masaki; Sato, Toru; Nakamura, Takuji; Saito, Akinori; Tomikawa, Yoshihiro; Nishimura, Koji; Kohma, Masashi; Yamagishi, Hisao; Yamanouchi, Takashi

    2014-10-01

    The PANSY radar is the first Mesosphere-Stratosphere-Troposphere/Incoherent Scatter (MST/IS) radar in the Antarctic region. It is a large VHF monostatic pulse Doppler radar operating at 47 MHz, consisting of an active phased array of 1045 Yagi antennas and an equivalent number of transmit-receive (TR) modules with a total peak output power of 500 kW. The first stage of the radar was installed at Syowa Station (69°00‧S, 39°35‧E) in early 2011, and is currently operating with 228 antennas and modules. This paper reports the project's scientific objectives, technical descriptions, and the preliminary results of observations made to date. The radar is designed to clarify the role of atmospheric gravity waves at high latitudes in the momentum budget of the global circulation in the troposphere, stratosphere and mesosphere, and to explore the dynamical aspects of unique polar phenomena such as polar mesospheric clouds (PMC) and polar stratospheric clouds (PSC). The katabatic winds as a branch of Antarctic tropospheric circulation and as an important source of gravity waves are also of special interest. Moreover, strong and sporadic energy inputs from the magnetosphere by energetic particles and field-aligned currents can be quantitatively assessed by the broad height coverage of the radar which extends from the lower troposphere to the upper ionosphere. From engineering points of view, the radar had to overcome restrictions related to the severe environments of Antarctic research, such as very strong winds, limited power availability, short construction periods, and limited manpower availability. We resolved these problems through the adoption of specially designed class-E amplifiers, light weight and tough antenna elements, and versatile antenna arrangements. Although the radar is currently operating with only about a quarter of its full designed system components, we have already obtained interesting results on the Antarctic troposphere, stratosphere and

  18. Antarctic meteor observations using the Davis MST and meteor radars

    NASA Astrophysics Data System (ADS)

    Holdsworth, David A.; Murphy, Damian J.; Reid, Iain M.; Morris, Ray J.

    2008-07-01

    This paper presents the meteor observations obtained using two radars installed at Davis (68.6°S, 78.0°E), Antarctica. The Davis MST radar was installed primarily for observation of polar mesosphere summer echoes, with additional transmit and receive antennas installed to allow all-sky interferometric meteor radar observations. The Davis meteor radar performs dedicated all-sky interferometric meteor radar observations. The annual count rate variation for both radars peaks in mid-summer and minimizes in early Spring. The height distribution shows significant annual variation, with minimum (maximum) peak heights and maximum (minimum) height widths in early Spring (mid-summer). Although the meteor radar count rate and height distribution variations are consistent with a similar frequency meteor radar operating at Andenes (69.3°N), the peak heights show a much larger variation than at Andenes, while the count rate maximum-to-minimum ratios show a much smaller variation. Investigation of the effects of the temporal sampling parameters suggests that these differences are consistent with the different temporal sampling strategies used by the Davis and Andenes meteor radars. The new radiant mapping procedure of [Jones, J., Jones, W., Meteor radiant activity mapping using single-station radar observations, Mon. Not. R. Astron. Soc., 367(3), 1050-1056, doi: 10.1111/j.1365-2966.2006.10025.x, 2006] is investigated. The technique is used to detect the Southern delta-Aquarid meteor shower, and a previously unknown weak shower. Meteoroid speeds obtained using the Fresnel transform are presented. The diurnal, annual, and height variation of meteoroid speeds are presented, with the results found to be consistent with those obtained using specular meteor radars. Meteoroid speed estimates for echoes identified as Southern delta-Aquarid and Sextantid meteor candidates show good agreement with the theoretical pre-atmospheric speeds of these showers (41 km s -1 and 32 km s -1

  19. Febrile seizures - what to ask your doctor

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000223.htm Febrile seizures - what to ask your doctor To use the ... enable JavaScript. Your child has had a febrile seizure. A simple febrile seizure stops by itself within ...

  20. Seizure. Fundamentals of drug management of epilepsy in the older patient.

    PubMed

    Rowan, A James

    2002-09-01

    Although commonly perceived as a condition of the young, epilepsy has a significant presence in the geriatric population. The most common seizure types in older persons are complex partial, simple partial, and secondarily generalized tonic clonic. Patient assessment and management objectives include determining the seizure type, calculating the risk of seizure recurrence, and determining whether to initiate anticonvulsant therapy. These objectives are pursued using clinical, electroencephalographic (EEG), and neuroimaging findings. Treatment can reduce the risk of recurrence and prevent injuries likely to occur among older persons experiencing seizures.

  1. Eye position effects on the remapped memory trace of visual motion in cortical area MST.

    PubMed

    Inaba, Naoko; Kawano, Kenji

    2016-02-23

    After a saccade, most MST neurons respond to moving visual stimuli that had existed in their post-saccadic receptive fields and turned off before the saccade ("trans-saccadic memory remapping"). Neuronal responses in higher visual processing areas are known to be modulated in relation to gaze angle to represent image location in spatiotopic coordinates. In the present study, we investigated the eye position effects after saccades and found that the gaze angle modulated the visual sensitivity of MST neurons after saccades both to the actually existing visual stimuli and to the visual memory traces remapped by the saccades. We suggest that two mechanisms, trans-saccadic memory remapping and gaze modulation, work cooperatively in individual MST neurons to represent a continuous visual world.

  2. [Gelastic seizures: etiology, semiology, therapeutic perspectives].

    PubMed

    Usacheva, E L; Mukhin, K Iu; Prityko, A G; Aĭvazian, S O; Kharlamov, L A; Shorina, M Iu

    2003-01-01

    Gelastic seizures (laughing seizures) are a rare type of epileptic seizure in which laugh in a main and dominating manifestation of the seizure. As a rule, the seizures are caused by organic cerebral pathology and are often reported as a specific epilepsy marker related to hypothalamic hamartoma. The interictal EEG frequently shows a focal activity. Based on examination of 2 patients with gelastic seizures and hypothalamic hamartoma, clinical features, EEG characteristics and therapeutic perspectives for the disorder are discussed.

  3. Anticonvulsant effect of xenon on neonatal asphyxial seizures.

    PubMed

    Azzopardi, Denis; Robertson, Nicola J; Kapetanakis, Andrew; Griffiths, James; Rennie, Janet M; Mathieson, Sean R; Edwards, A David

    2013-09-01

    Xenon, a monoatomic gas with very high tissue solubility, is a non-competitive inhibitor of N-methyl-D-aspartate (NMDA) glutamate receptor, has antiapoptotic effects and is neuroprotective following hypoxic ischaemic injury in animals. Xenon may be expected to have anticonvulsant effects through glutamate receptor blockade, but this has not previously been demonstrated clinically. We examined seizure activity on the real time and amplitude integrated EEG records of 14 full-term infants with perinatal asphyxial encephalopathy treated within 12 h of birth with 30% inhaled xenon for 24 h combined with 72 h of moderate systemic hypothermia. Seizures were identified on 5 of 14 infants. Seizures stopped during xenon therapy but recurred within a few minutes of withdrawing xenon and stopped again after xenon was restarted. Our data show that subanaesthetic levels of xenon may have an anticonvulsant effect. Inhaled xenon may be a valuable new therapy in this hard-to-treat population.

  4. Slow Spatial Recruitment of Neocortex during Secondarily Generalized Seizures and Its Relation to Surgical Outcome

    PubMed Central

    Martinet, Louis-Emmanuel; Ahmed, Omar J.; Lepage, Kyle Q.; Cash, Sydney S.

    2015-01-01

    Understanding the spatiotemporal dynamics of brain activity is crucial for inferring the underlying synaptic and nonsynaptic mechanisms of brain dysfunction. Focal seizures with secondary generalization are traditionally considered to begin in a limited spatial region and spread to connected areas, which can include both pathological and normal brain tissue. The mechanisms underlying this spread are important to our understanding of seizures and to improve therapies for surgical intervention. Here we study the properties of seizure recruitment—how electrical brain activity transitions to large voltage fluctuations characteristic of spike-and-wave seizures. We do so using invasive subdural electrode arrays from a population of 16 patients with pharmacoresistant epilepsy. We find an average delay of ∼30 s for a broad area of cortex (8 × 8 cm) to be recruited into the seizure, at an estimated speed of ∼4 mm/s. The spatiotemporal characteristics of recruitment reveal two categories of patients: one in which seizure recruitment of neighboring cortical regions follows a spatially organized pattern consistent from seizure to seizure, and a second group without consistent spatial organization of activity during recruitment. The consistent, organized recruitment correlates with a more regular, compared with small-world, connectivity pattern in simulation and successful surgical treatment of epilepsy. We propose that an improved understanding of how the seizure recruits brain regions into large amplitude voltage fluctuations provides novel information to improve surgical treatment of epilepsy and highlights the slow spread of massive local activity across a vast extent of cortex during seizure. PMID:26109670

  5. 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

  6. Environmental enrichment restores cognitive deficits induced by prenatal maternal seizure.

    PubMed

    Xie, Tao; Wang, Wei-ping; Jia, Li-jing; Mao, Zhuo-feng; Qu, Zhen-zhen; Luan, Shao-qun; Kan, Min-chen

    2012-08-27

    Maternal seizure has adverse effects on brain histology as well as on learning and memory ability in progeny. An enriched environment (EE) is known to promote structural changes in the brain and improve cognitive and motor deficits following a variety of brain injuries. Whether EE treatment in early postnatal periods could restore cognitive impairment induced by prenatal maternal seizure is unknown. Adult female Sprague-Dawley rats were randomly separated into two groups and were injected intraperitoneally either saline or pentylenetetrazol (PTZ) for 30 days. Then the fully kindled rats and control animals were allowed to mate. PTZ administration was continued until delivery, while the control group received saline at the same time. After weaning at postnatal day 22, one-half of the male offspring in the control and in the prenatal maternal group were given the environmental enrichment treatment through all the experiments until they were tested. Morris water maze testing was performed at 8 weeks of age. Western blot and synaptic ultrastructure analysis were then performed. We found that EE treatment reversed spatial learning deficits induced by prenatal maternal seizure. An EE also reversed the changes in synaptic ultrastructure following prenatal maternal seizure. In addition, prenatal maternal seizure significantly decreased phosphorylation states of cAMP response element binding (CREB) in the hippocampus, whereas EE reversed this reduced expression. These findings suggest that EE treatment on early postnatal periods could be a potential therapy for improving cognitive deficits induced by prenatal maternal seizure.

  7. Traumatic brain injury and epilepsy: Underlying mechanisms leading to seizure.

    PubMed

    Lucke-Wold, Brandon P; Nguyen, Linda; Turner, Ryan C; Logsdon, Aric F; Chen, Yi-Wen; Smith, Kelly E; Huber, Jason D; Matsumoto, Rae; Rosen, Charles L; Tucker, Eric S; Richter, Erich

    2015-12-01

    Post-traumatic epilepsy continues to be a major concern for those experiencing traumatic brain injury. Post-traumatic epilepsy accounts for 10-20% of epilepsy cases in the general population. While seizure prophylaxis can prevent early onset seizures, no available treatments effectively prevent late-onset seizure. Little is known about the progression of neural injury over time and how this injury progression contributes to late onset seizure development. In this comprehensive review, we discuss the epidemiology and risk factors for post-traumatic epilepsy and the current pharmacologic agents used for treatment. We highlight limitations with the current approach and offer suggestions for remedying the knowledge gap. Critical to this pursuit is the design of pre-clinical models to investigate important mechanistic factors responsible for post-traumatic epilepsy development. We discuss what the current models have provided in terms of understanding acute injury and what is needed to advance understanding regarding late onset seizure. New model designs will be used to investigate novel pathways linking acute injury to chronic changes within the brain. Important components of this transition are likely mediated by toll-like receptors, neuroinflammation, and tauopathy. In the final section, we highlight current experimental therapies that may prove promising in preventing and treating post-traumatic epilepsy. By increasing understanding about post-traumatic epilepsy and injury expansion over time, it will be possible to design better treatments with specific molecular targets to prevent late-onset seizure occurrence following traumatic brain injury.

  8. Prognosis of intractable epilepsy: is long-term seizure freedom possible with medical management?

    PubMed

    Munger Clary, Heidi; Choi, Hyunmi

    2011-08-01

    Until recently, very little data existed on long-term seizure prognosis of patients with intractable epilepsy. We review recent work that assessed seizure remission in patients with intractable epilepsy during medical management. Recent prevalence cohort studies among adults with longstanding intractable epilepsy have demonstrated notable proportions of patients attaining at least 1-year seizure freedom, ranging from more than 10% to nearly 30% of patients, when followed for mean duration of 18 months to 6 years. Additionally, a recent prospective cohort study of pediatric-onset intractable epilepsy (followed prospectively for seizure outcome from onset of intractability) revealed minimum 1-year seizure remission among more than half of study patients. Despite the notable rates of remission seen among patients with intractable epilepsy, many individuals experienced subsequent seizure relapse. These findings highlight the continued importance of surgical therapy for those who are good candidates and the need for further development of effective therapeutic interventions.

  9. A closed-loop brain computer interface for real-time seizure detection and control.

    PubMed

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

    2010-01-01

    The worldwide prevalence of epilepsy is approximately 1%, and 25% of epilepsy patients cannot be treated sufficiently by available therapies. Brain stimulation with closed-loop seizure control has recently been proposed as an innovative and effective alternative. In this paper, a portable closed-loop brain computer interface for seizure control was developed and shown with several aspects of advantages, including high seizure detection rate (92-99% during wake-sleep states), low false detection rate (1.2-2.5%), and small size. The seizure detection and electrical stimulation latency was not greater than 0.6 s after seizure onset. A wireless communication feature also provided flexibility for subjects freeing from the hassle of wires. Experimental data from freely moving rats supported the functional possibility of a real-time closed-loop seizure controller.

  10. 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 μg/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

  11. Recurrent seizures after lidocaine ingestion.

    PubMed

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

    2015-01-01

    Lidocaine has a concentration-dependent effect on seizures. Concentrations above 15 μg/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.

  12. Mouse repeated electroconvulsive seizure (ECS) does not reverse social stress effects but does induce behavioral and hippocampal changes relevant to electroconvulsive therapy (ECT) side-effects in the treatment of depression.

    PubMed

    van Buel, Erin M; Sigrist, Hannes; Seifritz, Erich; Fikse, Lianne; Bosker, Fokko J; Schoevers, Robert A; Klein, Hans C; Pryce, Christopher R; Eisel, Ulrich Lm

    2017-01-01

    Electroconvulsive therapy (ECT) is an effective treatment for depression, but can have negative side effects including amnesia. The mechanisms of action underlying both the antidepressant and side effects of ECT are not well understood. An equivalent manipulation that is conducted in experimental animals is electroconvulsive seizure (ECS). Rodent studies have provided valuable insights into potential mechanisms underlying the antidepressant and side effects of ECT. However, relatively few studies have investigated the effects of ECS in animal models with a depression-relevant manipulation such as chronic stress. In the present study, mice were first exposed to chronic social stress (CSS) or a control procedure for 15 days followed by ECS or a sham procedure for 10 days. Behavioral effects were investigated using an auditory fear conditioning (learning) and expression (memory) test and a treadmill-running fatigue test. Thereafter, immunohistochemistry was conducted on brain material using the microglial marker Iba-1 and the cholinergic fibre marker ChAT. CSS did not increase fear learning and memory in the present experimental design; in both the control and CSS mice ECS reduced fear learning and fear memory expression. CSS induced the expected fatigue-like effect in the treadmill-running test; ECS induced increased fatigue in CSS and control mice. In CSS and control mice ECS induced inflammation in hippocampus in terms of increased expression of Iba-1 in radiatum of CA1 and CA3. CSS and ECS both reduced acetylcholine function in hippocampus as indicated by decreased expression of ChAT in several hippocampal sub-regions. Therefore, CSS increased fatigue and reduced hippocampal ChAT activity and, rather than reversing these effects, a repeated ECS regimen resulted in impaired fear learning-memory, increased fatigue, increased hippocampal Iba-1 expression, and decreased hippocampal ChAT expression. As such, the current model does not provide insights into the

  13. Seizure Associated Takotsubo Syndrome: A Rare Combination

    PubMed Central

    Kyi, Htay Htay; Aljariri Alhesan, Nour; Upadhaya, Sunil

    2017-01-01

    Takotsubo cardiomyopathy (TC) is increasingly recognized in neurocritical care population especially in postmenopausal females. We are presenting a 61-year-old African American female with past medical history of epilepsy, bipolar disorder, and hypertension who presented with multiple episodes of seizures due to noncompliance with antiepileptic medications. She was on telemetry which showed ST alarm. Electrocardiogram (ECG) was ordered and showed ST elevation in anterolateral leads and troponins were positive. Subsequently Takotsubo cardiomyopathy was diagnosed by left ventriculography findings and absence of angiographic evidence of obstructive coronary artery disease. Echocardiogram showed apical hypokinesia, ejection fraction of 40%, and systolic anterior motion of mitral valve with hyperdynamic left ventricle, in the absence of intracoronary thrombus formation in the angiogram. Electroencephalography showed evidence of generalized tonic-clonic seizure. She was treated with supportive therapy. This case illustrates importance of ECG in all patients with seizure irrespective of cardiac symptoms as TC could be the cause of Sudden Unexpected Death in Epilepsy (SUDEP) and may be underdiagnosed and so undertreated. PMID:28811941

  14. INVESTIGATING SUSPENSION OF MST, CST, AND SIMULATED SLUDGE SLURRIES IN A PILOT-SCALE WASTE TANK

    SciTech Connect

    Poirier, M.; Qureshi, Z.; Restivo, M.; Steeper, T.; Williams, M.

    2011-05-24

    The Small Column Ion Exchange (SCIX) process is being developed to remove cesium, strontium, and actinides from Savannah River Site (SRS) Liquid Waste using an existing waste tank (i.e., Tank 41H) to house the process. Savannah River National Laboratory (SRNL) is conducting pilot-scale mixing tests to determine the pump requirements for suspending and resuspending monosodium titanate (MST), crystalline silicotitanate (CST), and simulated sludge. The purpose of this pilot scale testing is for the pumps to resuspend the MST, CST, and simulated sludge particles so that they can be removed from the tank, and to suspend the MST so it can contact strontium and actinides. The pilot-scale tank is a 1/10.85 linear scaled model of Tank 41H. The tank diameter, tank liquid level, pump nozzle diameter, pump elevation, and cooling coil diameter are all 1/10.85 of their dimensions in Tank 41H. The pump locations correspond to the proposed locations in Tank 41H by the SCIX program (Risers B5, B3, and B1). Previous testing showed that three Submersible Mixer Pumps (SMPs) will provide sufficient power to initially suspend MST in an SRS waste tank, and to resuspend MST that has settled in a waste tank at nominal 45 C for four weeks. The conclusions from this analysis are: (1) Three SMPs will be able to resuspend more than 99.9% of the MST and CST that has settled for four weeks at nominal 45 C. The testing shows the required pump discharge velocity is 84% of the maximum discharge velocity of the pump. (2) Three SMPs will be able to resuspend more than 99.9% of the MST, CST, and simulated sludge that has settled for four weeks at nominal 45 C. The testing shows the required pump discharge velocity is 82% of the maximum discharge velocity of the pump. (3) A contact time of 6-12 hours is needed for strontium sorption by MST in a jet mixed tank with cooling coils, which is consistent with bench-scale testing and actinide removal process (ARP) operation.

  15. Impact of MST on the Rheology of the Neutralized Am/Cm Slurry

    SciTech Connect

    Lambert, D.P.; Peters, T.B.

    2001-08-20

    The americium (Am) and curium (Cm) solution, currently stored in F-Canyon Tank 17.1 will be neutralized and diluted prior to addition to High Level Waste (HLW) sludge batch 3 to eliminate the cost and uncertainty of processing and vitrifying this solution. One of the processing alternatives involves the addition of monosodium titanate (MST) to adsorb any soluble Am, Cm or Pu present in the slurry. This paper discusses the impact of the MST on the rheology of the neutralized Am/Cm slurry.

  16. STRONTIUM AND ACTINIDE SORPTION BY MST AND MMST UNDER CONDITIONS REVELANT TO THE SMALL COLUMN ION-EXCHANGE PROCESS

    SciTech Connect

    Taylor-Pashow, K.; Hobbs, D.; Poirier, M.

    2011-05-06

    A series of tests were performed to examine the kinetics of Sr and actinide removal by monosodium titanate (MST) and modified monosodium titanate (mMST) under mixing conditions similar to what will be provided in the Small Column Ion Exchange (SCIX) Program. Similar removal kinetics were seen for two different mixing energies, indicating that under these conditions bulk solution transport is not the rate limiting step for Sr and actinide removal. Sr removal was found to be rapid for both MST and mMST, reaching steady-state conditions within six hours. In contrast, at least six weeks is necessary to reach steady-state conditions for Pu with MST. For mMST, steady-state conditions for Pu were achieved within two weeks. The actual contact time required for the SCIX process will depend on starting sorbate concentrations as well as the requirements for the decontaminated salt solution. During testing leaks occurred in both the MST and mMST tests and evidence of potential desorption was observed. The desorption likely occurred as a result of the change in solids to liquid phase ratio that occurred due to the loss of solution. Based on these results, Savannah River National Laboratory (SRNL) recommended additional testing to further study the effect of changing phase ratios on desorption. This testing is currently in progress and results will be documented in a separate report.

  17. [Reflex seizures, cinema and television].

    PubMed

    Olivares-Romero, Jesús

    2015-12-16

    In movies and television series are few references to seizures or reflex epilepsy even though in real life are an important subgroup of total epileptic syndromes. It has performed a search on the topic, identified 25 films in which they appear reflex seizures. Most seizures observed are tonic-clonic and visual stimuli are the most numerous, corresponding all with flashing lights. The emotions are the main stimuli in higher level processes. In most cases it is not possible to know if a character suffers a reflex epilepsy or suffer reflex seizures in the context of another epileptic syndrome. The main conclusion is that, in the movies, the reflex seizures are merely a visual reinforcing and anecdotal element without significant influence on the plot.

  18. Cortical deactivation induced by subcortical network dysfunction in limbic seizures

    PubMed Central

    Englot, Dario J.; Modi, Badri; Mishra, Asht M.; DeSalvo, Matthew; Hyder, Fahmeed; Blumenfeld, Hal

    2009-01-01

    Normal human consciousness may be impaired by two possible routes: direct reduced function in widespread cortical regions, or indirect disruption of subcortical activating systems. The route through which temporal lobe limbic seizures impair consciousness is not known. We recently developed an animal model which, like human limbic seizures, exhibits neocortical deactivation including cortical slow waves and reduced cortical cerebral blood flow (CBF). We now find through functional MRI (fMRI) that electrically-stimulated hippocampal seizures in rats cause increased activity in subcortical structures including the septal area and mediodorsal thalamus, along with reduced activity in frontal, cingulate, and retrosplenial cortex. Direct recordings from the hippocampus, septum, and medial thalamus demonstrated fast poly-spike activity associated with increased neuronal firing and CBF, while frontal cortex showed slow oscillations with decreased neuronal firing and CBF. Stimulation of septal area, but not hippocampus or medial thalamus, in the absence of a seizure resulted in cortical deactivation with slow oscillations and behavioral arrest, resembling changes seen during limbic seizures. Transecting the fornix, the major route from hippocampus to subcortical structures, abolished the negative cortical and behavioral effects of seizures. Cortical slow oscillations and behavioral arrest could be reconstituted in fornix-lesioned animals by inducing synchronous activity in the hippocampus and septal area, implying involvement of a downstream region converged upon by both structures. These findings suggest that limbic seizures may cause neocortical deactivation indirectly, through impaired subcortical function. If confirmed, subcortical networks may represent a target for therapies aimed at preserving consciousness in human temporal lobe seizures. PMID:19828814

  19. 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

  20. Audiogenic reflex seizures in cats

    PubMed Central

    Lowrie, Mark; Bessant, Claire; Harvey, Robert J; Sparkes, Andrew; Garosi, Laurent

    2015-01-01

    Objectives This study aimed to characterise feline audiogenic reflex seizures (FARS). Methods An online questionnaire was developed to capture information from owners with cats suffering from FARS. This was collated with the medical records from the primary veterinarian. Ninety-six cats were included. Results Myoclonic seizures were one of the cardinal signs of this syndrome (90/96), frequently occurring prior to generalised tonic–clonic seizures (GTCSs) in this population. Other features include a late onset (median 15 years) and absence seizures (6/96), with most seizures triggered by high-frequency sounds amid occasional spontaneous seizures (up to 20%). Half the population (48/96) had hearing impairment or were deaf. One-third of cats (35/96) had concurrent diseases, most likely reflecting the age distribution. Birmans were strongly represented (30/96). Levetiracetam gave good seizure control. The course of the epilepsy was non-progressive in the majority (68/96), with an improvement over time in some (23/96). Only 33/96 and 11/90 owners, respectively, felt the GTCSs and myoclonic seizures affected their cat’s quality of life (QoL). Despite this, many owners (50/96) reported a slow decline in their cat’s health, becoming less responsive (43/50), not jumping (41/50), becoming uncoordinated or weak in the pelvic limbs (24/50) and exhibiting dramatic weight loss (39/50). These signs were exclusively reported in cats experiencing seizures for >2 years, with 42/50 owners stating these signs affected their cat’s QoL. Conclusions and relevance In gathering data on audiogenic seizures in cats, we have identified a new epilepsy syndrome named FARS with a geriatric onset. Further studies are warranted to investigate potential genetic predispositions to this condition. PMID:25916687

  1. Effects of Multisystemic Therapy through Midlife: A 21.9-Year Follow-Up to a Randomized Clinical Trial with Serious and Violent Juvenile Offenders

    ERIC Educational Resources Information Center

    Sawyer, Aaron M.; Borduin, Charles M.

    2011-01-01

    Objective: Although current evidence suggests that the positive effects of multisystemic therapy (MST) on serious crime reach as far as young adulthood, the longer term impact of MST on criminal and noncriminal outcomes in midlife has not been evaluated. In the present study, the authors examined a broad range of criminal and civil court outcomes…

  2. Effects of Multisystemic Therapy through Midlife: A 21.9-Year Follow-Up to a Randomized Clinical Trial with Serious and Violent Juvenile Offenders

    ERIC Educational Resources Information Center

    Sawyer, Aaron M.; Borduin, Charles M.

    2011-01-01

    Objective: Although current evidence suggests that the positive effects of multisystemic therapy (MST) on serious crime reach as far as young adulthood, the longer term impact of MST on criminal and noncriminal outcomes in midlife has not been evaluated. In the present study, the authors examined a broad range of criminal and civil court outcomes…

  3. Pediatric seizure disorders in dogs and cats.

    PubMed

    Lavely, James A

    2014-03-01

    Seizure disorders in young animals pose different considerations as to cause and therapeutic decisions compared with adult animals. Infectious diseases of the nervous system are more likely in puppies and kittens compared with adults. The diagnosis of canine distemper is often based on clinical signs. Idiopathic epilepsy typically occurs in dogs between 1 and 5 years of age; however, inflammatory brain diseases such as necrotizing encephalitis and granulomatous meningoencephalomyelitis also commonly occur in young to middle-aged small-breed dogs. The choice of which anticonvulsant to administer for maintenance therapy is tailored to each individual patient.

  4. 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.

  5. Treating acute seizures with benzodiazepines: does seizure duration matter?

    PubMed

    Naylor, David E

    2014-10-01

    Several clinical trials have shown improved seizure control and outcome by early initiation of treatment with benzodiazepines, before arrival in the emergency department and before intravenous access can be established. Here, evidence is provided and reviewed for rapid treatment of acute seizures in order to avoid the development of benzodiazepine pharmacoresistance and the emergence of self-sustaining status epilepticus. Alterations in the physiology, pharmacology, and postsynaptic level of GABA-A receptors can develop within minutes to an hour and hinder the ability of synaptic inhibition to stop seizures while also impairing the efficacy of GABAergic agents, such as benzodiazepines, to boost impaired inhibition. In addition, heightened excitatory transmission further exacerbates the inhibitory/excitatory balance and makes seizure control even more resistant to treatment. The acute increase in the surface expression of NMDA receptors during prolonged seizures also may cause excitotoxic injury, cell death, and other pathological expressions and re-arrangements of receptor subunits that all contribute to long-term sequelae such as cognitive impairment and chronic epilepsy. In conclusion, a short window of opportunity exists when seizures are maximally controlled by first-line benzodiazepine treatment. After that, multiple pathological mechanisms quickly become engaged that make seizures increasingly more difficult to control with high risk for long-term harm.

  6. PDCD10 interacts with Ste20-related kinase MST4 to promote cell growth and transformation via modulation of the ERK pathway.

    PubMed

    Ma, Xi; Zhao, Hongshan; Shan, Jingxuan; Long, Feng; Chen, Yaoyao; Chen, Yingyu; Zhang, Yingmei; Han, Xiao; Ma, Dalong

    2007-06-01

    PDCD10 (programmed cell death 10, TFAR15), a novel protein associated with cell apoptosis has been recently implicated in mutations associated with Cerebral Cavernous Malformations (CCM). Yeast two-hybrid screening revealed that PDCD10 interacts with MST4, a member of Ste20-related kinases. This interaction was confirmed by coimmunoprecipitation and colocalization assays in mammalian cells. Furthermore, the co-overexpression of PDCD10 and MST4 promoted cell proliferation and transformation via modulation of the extracellular signal-regulated kinase (ERK) pathway. Potent short interfering RNAs (siRNAs) against PDCD10 (siPDCD10) and MST4 (siMST4) were designed to specifically inhibit the expression of PDCD10 and MST4 mRNA, respectively. The induction of siPDCD10 or siMST4 resulted in decreased expression of endogenous PDCD10 or MST4, which was accompanied by reduced ERK activity and attenuated cell growth and anchorage-independent growth. On the other hand, siMST4 had similar effects in PDCD10-overexpressed cells. And more importantly, we confirmed that either overexpressing or endogenous PDCD10 can increase the MST4 kinase activity in vitro. Our results demonstrated that PDCD10 modulation of ERK signaling was mediated by MST4, and PDCD10 could be a regulatory adaptor necessary for MST4 function, suggesting a link between cerebral cavernous malformation pathogenesis and the ERK-MAPK cascade via PDCD10/MST4.

  7. Semiology of hypermotor (hyperkinetic) seizures.

    PubMed

    Alqadi, Khalid; Sankaraneni, Ram; Thome, Ursula; Kotagal, Prakash

    2016-01-01

    Hypermotor seizures (HMSs) consist of complex movements involving proximal segments of the limbs and trunk that appear violent and inappropriate for the situation. We analyzed hypermotor seizure videos in seizure-free patients (Engel class I) following resective epilepsy surgery. After completion of video analysis, we reviewed EEG and neuroimaging data. Search of our epilepsy surgery database yielded 116 patients classified as having hypermotor seizures between 1996 and 2013. From this subset, 17/31 (55%) patients had been seizure-free for >6months (mean follow-up: 3.3years). Mean seizure duration was 35s (range: 6-91s), of which the HM phase lasted a mean of 22s (range: 3-53s). In 16 patients (95%), hypermotor activity was seen at or within 10s of clinical seizure onset. Type I semiology occurred in 6 patients, type II semiology in 10 patients, and 1 patient exhibited features of both. Type I and type II semiologies were noted in patients who had frontal lobe as well as extrafrontal resections. Nonversive head and body turning occurred in 10 patients (ranging from 90° to 270°) which was ipsilateral to the side of resection in all patients and seen both in frontal and extrafrontal resections. Six out of eleven patients with abnormal MRI and 4/6 patients with nonlesional MRI underwent invasive EEG evaluation. Eight patients (47%) had frontal lobe resection, 4/17 (23%) patients had temporal lobe resection, and one patient each had parietal lobe, insular, temporoparietooccipital, or motor sparing resection; 1 patient had functional hemispherectomy. Hypermotor semiology typically occurs at or within 10s after seizure onset. Ipsilateral head/body turning appears to be of lateralizing value whereas asymmetry of limb movement was not lateralizing. Hypermotor semiology is most often seen in frontal lobe epilepsy but may occur in seizures arising from other locations. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. 26. GENERAL VIEW OF SLC3W MST STATION 63 (TOP SERVICE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    26. GENERAL VIEW OF SLC-3W MST STATION 63 (TOP SERVICE STATION FOR DELIVERY VEHICLE) FROM NORTHEAST CORNER SHOWING REMOVABLE SAFETY RAILS SURROUNDING CENTRAL OPENING, PULLEY AND WINCH SYSTEM FOR RAISING SERVICE PLATFORM, AND PLATFORM HINGES - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  9. 22. DOOR CONTROL BOX AT STATION 70.5 OF MST FOR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. DOOR CONTROL BOX AT STATION 70.5 OF MST FOR CONTROL OF SOUTH DOORS. NITROGEN PRESSURE REGULATOR ON LEFT. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  10. 30. DETAIL OF CONTROL PANEL FOR SLC3W MST ENVIRONMENTAL DOORS. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    30. DETAIL OF CONTROL PANEL FOR SLC-3W MST ENVIRONMENTAL DOORS. CONTROL PANEL LOCATED IN NORTHEAST CORNER OF STATION 70.5. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  11. '"My Land, Your Social Transformation": Conflicts within the Landless People Movement (MST), Rio De Janeiro, Brazil

    ERIC Educational Resources Information Center

    Caldeira, Rute

    2008-01-01

    The Brazilian "Movimento dos Trabalhadores Rurais Sem-Terra" (MST) is one of the best-known and most prominent rural social movements. The unequal distribution of land in Brazil, and the neglect of this problem by successive Brazilian governments contributed greatly to the organisation of rural movements striving for the implementation…

  12. 23. STATION 85.5 OF MST, WEST SIDE. ACTUATOR FOR MIDDLE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    23. STATION 85.5 OF MST, WEST SIDE. ACTUATOR FOR MIDDLE NORTH DOORS AT TOP; WEST DOOR MOTOR DISCONNECT ABOVE ACTUATOR; WINCH AND PULLEY SYSTEM AT BOTTOM; HYDRAULIC PUMPING UNIT ABOVE WINCHES; MOTOR COMPRESSOR FOR DOORS ON RIGHT. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  13. 9. VIEW OF SOUTH FACE OF SLC3W MST WITH ENVIRONMENTAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. VIEW OF SOUTH FACE OF SLC-3W MST WITH ENVIRONMENTAL DOORS OPEN AND SERVICE PLATFORMS RAISED. LAUNCHER VISIBLE BELOW LOWEST SET OF ENVIRONMENTAL DOORS. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  14. Empirical vs. Expected IRT-Based Reliability Estimation in Computerized Multistage Testing (MST)

    ERIC Educational Resources Information Center

    Zhang, Yanwei; Breithaupt, Krista; Tessema, Aster; Chuah, David

    2006-01-01

    Two IRT-based procedures to estimate test reliability for a certification exam that used both adaptive (via a MST model) and non-adaptive design were considered in this study. Both procedures rely on calibrated item parameters to estimate error variance. In terms of score variance, one procedure (Method 1) uses the empirical ability distribution…

  15. 21. STATION 70.5 OF MST, WEST SIDE. AIRCONDITIONING DUCT AT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. STATION 70.5 OF MST, WEST SIDE. AIR-CONDITIONING DUCT AT TOP; POWER BOX ON RIGHT; WINCH ON LEFT. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  16. 37. GENERAL VIEW OF SLC3W MST STATION 85.5 FROM NORTHEAST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    37. GENERAL VIEW OF SLC-3W MST STATION 85.5 FROM NORTHEAST CORNER SHOWING PLATFORM CONTROLS IN SOUTHWEST CORNER, COMMUNICATION STATION AND ELEVATOR ON WEST SIDE. STRETCH SLING CYLINDER PRESSURE GAUGE IN SOUTHWEST CORNER OF STATION 78 VISIBLE THROUGH CENTRAL OPENING. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  17. '"My Land, Your Social Transformation": Conflicts within the Landless People Movement (MST), Rio De Janeiro, Brazil

    ERIC Educational Resources Information Center

    Caldeira, Rute

    2008-01-01

    The Brazilian "Movimento dos Trabalhadores Rurais Sem-Terra" (MST) is one of the best-known and most prominent rural social movements. The unequal distribution of land in Brazil, and the neglect of this problem by successive Brazilian governments contributed greatly to the organisation of rural movements striving for the implementation…

  18. Reframing the Public in Public Education: The Landless Workers Movement (MST) and Adult Education in Brazil

    ERIC Educational Resources Information Center

    Thapliyal, Nisha

    2013-01-01

    Education for rural Brazilians has historically been dominated by two imperatives: human capital and political patronage. For the last four decades, the Landless Workers Movement (MST) have maintained a struggle to democratise public education and democracy itself. In this article, I make a situated analysis of the educational politics of the MST…

  19. PHLPP1 regulates contact inhibition by dephosphorylating Mst1 at the inhibitory site

    SciTech Connect

    Jung, Sujin; Kang, Jeong Gu; Lee, Ju Hee; Song, Kyoung Jin; Ko, Jeong-Heon; Kim, Yong-Sam

    2014-01-24

    Highlights: • PHLPP1 regulates contact inhibition by dephosphorylating Mst1 at Thr{sup 387}. • Overexpression of PHLPP1 sensitizes contact inhibition. • Tumor cells with suppressed PHLPP1 expression are refractory to apoptosis and highly proliferative. • Loss or down-regulation of PHLPP1 may drive tumor development and progression. - Abstract: Contact inhibition has been largely elusive despite that a loss of contact inhibition is a critical event for cancer development and progression. Here, we report that PHLPP1 is a binding protein for Mst1 and it modulates the Hippo pathway by dephosphorylating Mst1 at the inhibitory Thr{sup 387} of Mst1. Yap1 was localized predominantly in the nucleus but marginally in the cytoplasm in HeLa cells under sparse conditions, whereas the functional protein was more directed to sequestration in the cytoplasm under dense environments. Furthermore, loss of PHLPP1 resulted in a failure of the apoptotic control. It is interesting that down-regulated expression of PHLPP1 appears to mimic the loss of contact inhibition, a hallmark of cancer.

  20. High-Repetition-Rate Laser for Thomson Scattering on the MST Reversed-Field Pinch

    NASA Astrophysics Data System (ADS)

    Young, William C.; Morton, L. A.; Parke, E.; den Hartog, D. J.; MST Team

    2013-10-01

    The MST Thomson scattering diagnostic has operated with a new, high-repetition-rate laser system, demonstrating 2 J pulses at repetition rates up to 50 kHz. The pulse repetition rate can maintain 2 J pulses for bursts of 5 kHz (sustained for 5 ms), to 50 kHz (for 10 bursts of 240 μs each). The 1064 nm laser currently employs a q-switched, diode pumped Nd:YVO4 master oscillator, four Nd:YAG amplifier stages, and a Nd:glass amplifier. The future implementation of the full laser as designed, including a second Nd:glass amplifier, is expected to produce bursts of 2 J pulses at a repetition rate of at least 250 kHz. The new laser integrates with the same collection optics and detectors as used by the present MST Thomson scattering system: 21 spatial points across the MST minor radius with sensitivity over a 10 eV-5 keV range. Initial results will be presented from application of this diagnostic to parametric scans of MST plasmas, evolution of energy confinement during spontaneous enhanced confinement periods, and non-Maxwellian electron distributions. Work Supported by the U. S. Department of Energy and National Science Foundation.

  1. Mesospheric wave number spectra from Poker Flat MST radar measurements compared with gravity-wave model

    NASA Technical Reports Server (NTRS)

    Smith, S. A.; Fritts, D. C.; Vanzandt, T. E.

    1986-01-01

    The results of a comparison of mesospheric wind fluctuation spectra computed from radial wind velocity estimates made by the Poker Flat mesosphere-stratosphere-troposphere (MST) radar are compared with a gravity-wave model developed by VanZandt (1982, 1985). The principal conclusion of this comparison is that gravity waves can account for 80% of the mesospheric power spectral density.

  2. 36. GENERAL VIEW OF SLC3W MST STATION 85.5 FROM SOUTHEAST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    36. GENERAL VIEW OF SLC-3W MST STATION 85.5 FROM SOUTHEAST CORNER SHOWING REMOVABLE SAFETY RAILS AROUND CENTRAL OPENING, STRETCH SLING CYLINDER, AND PULLEY ON WEST SIDE, AIR-CONDITIONING DUCTING IN NORTHWEST CORNER, PLATFORM SEGMENTS AND HINGES - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  3. 39. NORTH WALL OF MST AT STATION 124. 480VOLT MASTER ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    39. NORTH WALL OF MST AT STATION 124. 480-VOLT MASTER POWER SHUTOFF AND CIRCUIT BREAKERS FOR CRANE NORTH DOORS/CRANE SOUTH DOORS ON LEFT; FOR BRIDGE CRANE AND DUCT HEATER 122 ON RIGHT. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  4. Reframing the Public in Public Education: The Landless Workers Movement (MST) and Adult Education in Brazil

    ERIC Educational Resources Information Center

    Thapliyal, Nisha

    2013-01-01

    Education for rural Brazilians has historically been dominated by two imperatives: human capital and political patronage. For the last four decades, the Landless Workers Movement (MST) have maintained a struggle to democratise public education and democracy itself. In this article, I make a situated analysis of the educational politics of the MST…

  5. Mechanisms and Treatment of OP-Induced Seizures and Neuropathology

    DTIC Science & Technology

    1993-08-18

    may also potentiate the actions of NE in the CNS. Recent data have shown that NPY is released in high quantities in the brain during electroconvulsive ...alternative therapy . .Lindependence.i seizures and ACh after induction of convulsloll. The possibility that, after some threshold is passed...Sci, USA, 82(1985) 6344-6348. 121 McDonough, J. H., Jaax, N. K., Crowley, R. A., Mays, M. Z. and Modrow, H. E., Atropine and/or diazepam therapy

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

    PubMed Central

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

    2014-01-01

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

  7. Semiological seizure classification: before and after video-EEG monitoring of seizures.

    PubMed

    Hirfanoglu, Tugba; Serdaroglu, Ayse; Cansu, Ali; Bilir, Erhan; Gucuyener, Kivilcim

    2007-04-01

    The study objective was to assess the applicability and reliability of the semiological seizure classification in children with epilepsy in outpatient clinics. Ninety patients (age range, 2-16 years) who experienced clinical seizures during prolonged video-electroencephalogram (EEG) monitoring were evaluated. Semiological seizure classification was performed, first based on history obtained from parents of the patient during outpatient follow-up visits and then based on video EEG-monitoring. Kappa statistics (kappa) were used to evaluate the consistency of the two rounds of semiological seizure classification. Classification based on history yielded the following distribution: simple motor seizures (66.3%), aura (28%), complex motor seizures (15.8%), special seizures (15.8%), dialeptic seizures (9.3%), and autonomic seizures (3.7%). Classification based on video EEG-monitoring yielded a different distribution: simple motor seizures (55.7%), complex motor seizures (26.9%), automotor seizures (26.9%), aura (23%), dialeptic seizures (22.1%), special seizures (9.6%), and autonomic seizures (1.9%). Negative myoclonic seizures (kappa = 1, P = 0.000) and hypermotor seizures (kappa = 0.85, P = 0.000) had excellent consistency; somatosensory aura (kappa = 0.26, P = 0.012) and automotor seizures (kappa = 0.28, P = 0.004) had the lowest consistency. The families or doctors often defined simple motor seizures (decrease of 10.6% from before to after monitoring, kappa = 0.44); the proportion of complex motor seizures changed rather from before to after monitoring (11.1%, kappa = 0.33). Generally, parents can describe seizures quite well. We suggest that semiological seizure classification is a reliable method applicable for everyday use during outpatient visits, especially if seizure semiology is evaluated individually for each component or if the semiological seizure classification is modified or refined for some seizure components (tonic, clonic, versive, conscious, automotor

  8. Evaluation of no-MST operations in the SRS ARP for Hanford LAWPS

    SciTech Connect

    Herman, D.

    2016-11-14

    The Savannah River Site (SRS) Actinide Removal Process has been processing salt waste since 2008. This process includes a filtration step in the 512-S facility. Initial operations included the addition, or strike, of monosodium titanate (MST) to remove soluble actinides and strontium. The added MST and any entrained sludge solids were then separated from the supernate by cross flow filtration. During this time, the filter operations have, on many occasions, been the bottleneck process limiting the rate of salt processing. Recently, 512-S- has started operations utilizing “No-MST” where the MST actinide removal strike was not performed and the supernate was simply pre-filtered prior to Cs removal processing. Direct filtration of decanted tank supernate, as demonstrated in 512-S, is the proposed method of operation for the Hanford Low Activity Waste Pretreatment System (LAWPS) facility. Processing decanted supernate without MST solids has been demonstrated for cross flow filtration to provide a significant improvement in production with the SRS Salt Batches 8 and 9 feed chemistries. The average filtration rate for the first 512-S batch processing cycle using No-MST has increased filtrate production by over 35% of the historical average. The increase was sustained for more than double the amount of filtrate batches processed before cleaning of the filter was necessary. While there are differences in the design of the 512-S and Hanford filter systems, the 512-S system should provide a reasonable indication of LAWPS filter performance with similar feed properties. Based on the data from the 512-S facility and with favorable feed properties, the LAWPS filter, as currently sized at over twice the size of the 512-S filter (532 square feet filtration area versus 235 square feet), has the potential to provide sustained filtrate production at the upper range of the planned LAWPS production rate of 17 gpm.

  9. MST-GEN: An Efficient Parameter Selection Method for One-Class Extreme Learning Machine.

    PubMed

    Wang, Siqi; Liu, Qiang; Zhu, En; Yin, Jianping; Zhao, Wentao

    2017-10-01

    One-class classification (OCC) models a set of target data from one class to detect outliers. OCC approaches like one-class support vector machine (OCSVM) and support vector data description (SVDD) have wide practical applications. Recently, one-class extreme learning machine (OCELM), which inherits the fast learning speed of original ELM and achieves equivalent or higher data description performance than OCSVM and SVDD, is proposed as a promising alternative. However, OCELM faces the same thorny parameter selection problem as OCSVM and SVDD. It significantly affects the performance of OCELM and remains under-explored. This paper proposes minimal spanning tree (MST)-GEN, an automatic way to select proper parameters for OCELM. Specifically, we first build a n -round MST to model the structure and distribution of the given target set. With information from n -round MST, a controllable number of pseudo outliers are generated by edge pattern detection and a novel "repelling" process, which readily overcomes two fundamental problems in previous outlier generation methods: where and how many pseudo outliers should be generated. Unlike previous methods that only generate pseudo outliers, we further exploit n -round MST to generate pseudo target data, so as to avoid the time-consuming cross-validation process and accelerate the parameter selection. Extensive experiments on various datasets suggest that the proposed method can select parameters for OCELM in a highly efficient and accurate manner when compared with existing methods, which enables OCELM to achieve better OCC performance in OCC applications. Furthermore, our experiments show that MST-GEN can also be favorably applied to other prevalent OCC methods like OCSVM and SVDD.

  10. Recent Research on Febrile Seizures: A Review

    PubMed Central

    Syndi Seinfeld, DO; Pellock, John M.

    2014-01-01

    Febrile seizures are common and mostly benign. They are the most common cause of seizures in children less than five years of age. There are two categories of febrile seizures, simple and complex. Both the International League against Epilepsy and the National Institute of Health has published definitions on the classification of febrile seizures. Simple febrile seizures are mostly benign, but a prolonged (complex) febrile seizure can have long term consequences. Most children who have a febrile seizure have normal health and development after the event, but there is recent evidence that suggests a small subset of children that present with seizures and fever may have recurrent seizure or develop epilepsy. This review will give an overview of the definition of febrile seizures, epidemiology, evaluation, treatment, outcomes and recent research. PMID:25383238

  11. Heterogeneity in Response during Multisystemic Therapy: Exploring Subgroups and Predictors.

    PubMed

    Mertens, Esther C A; Deković, Maja; Asscher, Jessica J; Manders, Willeke A

    2016-12-29

    Multiple studies have shown that Multisystemic Therapy (MST) is, at group level, an effective treatment for adolescents showing serious externalizing problem behavior. The current study expands previous research on MST by, first, examining whether subgroups of participants who respond differently to treatment could be identified. Second, we investigated if the different trajectories of change during MST could be predicted by individual (hostile attributions) and contextual (parental sense of parenting competence and deviant and prosocial peer involvement) pre-treatment factors. Participants were 147 adolescents (mean age = 15.91 years, 104 (71%) boys) and their parents who received MST. Pre-treatment assessment of the predictors and 5 monthly assessments of externalizing behavior during treatment took place using both adolescent and parents' self-reports. Six distinct subgroups, showing different trajectories of change in externalizing problem behavior during MST, were identified. Two of the 6 trajectories of change showed a poor treatment response, as one class did not change in externalizing problem behavior and the other class even increased. The remaining 4 trajectories displayed a positive effect of MST, by showing a decrease in externalizing behavior. Most of these trajectories could be predicted by parental sense of parenting competence. Additionally, lower involvement with prosocial peers was a predictor of the group that appeared to be resistant to MST. Adolescents do respond differently to MST, which indicates the importance of personalizing treatment. Protective factors, such as parental sense of parenting competence and prosocial peers, seem to require additional attention in the first phase of MST.

  12. Prognosis of juvenile myoclonic epilepsy 45 years after onset: seizure outcome and predictors.

    PubMed

    Senf, Philine; Schmitz, Bettina; Holtkamp, Martin; Janz, Dieter

    2013-12-10

    Juvenile myoclonic epilepsy (JME) is the most common idiopathic generalized epilepsy subsyndrome, contributing to approximately 3% to 11% of adolescent and adult cases of epilepsy. However, little is known about the long-term medical evolution of this clinical entity. The aim of this study was to analyze long-term outcome in a clinically well-defined series of patients with JME for seizure evolution and predictors of seizure outcome. In this retrospective cohort study, we analyzed seizure outcome in 66 patients who had JME, were treated at the Department of Neurology, Charité-Universitätsmedizin Berlin, and were initially diagnosed by a single senior epileptologist. After a mean follow-up time of 44.6 years (20-69 years), 59.1% of patients remained free of seizures for at least 5 years before the last contact. Among the seizure-free patients, 28 (71.8%) were still taking antiepileptic drugs and 11 (28.2%) were off medication for at least the last 5 years. We identified manifestation of additional absence seizures at onset of JME as an independent predictor of an unfavorable outcome regarding seizure freedom. A significant proportion of patients with JME were seizure-free and off antiepileptic drug therapy in the later course of their disorder. Patients with JME and additional absence seizures might represent a different JME subtype with a worse outcome.

  13. Assessing Systems of Care for US Children with Epilepsy/Seizure Disorder

    PubMed Central

    Kenney, Mary Kay; Mann, Marie

    2013-01-01

    Background. The proportion of US children with special health care needs (CSHCN) with epilepsy/seizure disorder who receive care in high-quality health service systems was examined. Methodology. We analyzed data for 40,242 CSHCN from the 2009-2010 National Survey of CSHCN and compared CSHCN with epilepsy/seizure disorder to CSHCN without epilepsy/seizure disorder. Measures included attainment rates for 6 federal quality indicators with comparisons conducted using chi square and logistic regression methods. In addition, CSHCN with epilepsy/seizure disorder were compared to CSHCN without epilepsy/seizure disorder on the basis of 14 unmet health care needs. Results. Lower attainment rates for receiving comprehensive care in a medical home and easily accessible community-based services were found for CSHCN with epilepsy/seizure disorder versus CSHCN without epilepsy/seizure disorder (medical home: 32% versus 43%; accessible community-based services: 50% versus 66%, resp.) in unadjusted analyses. Lower adjusted odds for these indicators as well as greater unmet need for specialists, dentistry, prescriptions, therapies, and mental health care were also found for CSHCN with epilepsy/seizure disorder. Conclusions. Further efforts are needed to improve attainment of high-quality health care services for CSHCN with epilepsy/seizure disorders. PMID:24228175

  14. Migration stimulation factor (MStF), from murine B cells, constitutively produced by a T-B hybridoma.

    PubMed

    Gauthier-Rahman, S; el-Gharbi, N; Bouvet, J P; Goodhart, M; Decreusefond, C; Couderc, J

    1992-10-01

    Hybridomas were established between murine spleen B cells and the thymoma cell line BW5147, to purify the migration stimulation factor (MStF), a molecule likely involved in immunosuppression. The parental B cells were from Lo/PHA mice previously shown to produce high levels of MStF after immunization by appropriate (tolerogenic) doses of ovalbumin. Among the positive clones, B9 was selected, since it produced high levels of MStF constitutively, and no immunoglobulin. This clone was shown to contain the genome of the B-cell fusion partner, since one of its L chain genes had undergone a VK-JK rearrangement. Isolation of MStF by size-exclusion chromatography showed 2 major peaks of activity, one of which eluted in a 20-kDa, almost protein-free fraction. This elution is unlikely to correspond to the true molecular mass, since MStF was found not to be a protein. Indeed, MStF was TCA-soluble, thermoresistant, highly hydrophobic and protease-resistant, but activity was abolished by neuraminidase digestion. The possibility of its being a small molecule transported by a protein carrier was also ruled out. These results suggest that MStF is a complex molecule containing both sialic residues and a lipid moiety. Experiments are planned to further investigate the chemical structure of this unusual B-cell factor.

  15. Occipital seizures imitating migraine aura.

    PubMed Central

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

    1997-01-01

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

  16. Dissociation of spontaneous seizures and brainstem seizure thresholds in mice exposed to eight flurothyl-induced generalized seizures

    PubMed Central

    Kadiyala, Sridhar B.; Ferland, Russell J.

    2017-01-01

    Summary Objective C57BL/6J mice exposed to eight flurothyl-induced generalized clonic seizures exhibit a change in seizure phenotype following a 28-day incubation period and subsequent flurothyl rechallenge. Mice now develop a complex seizure semiology originating in the forebrain and propagating into the brainstem seizure network (a forebrain→brainstem seizure). In contrast, this phenotype change does not occur in seizure-sensitive DBA/2J mice. The underlying mechanism(s) was the focus of these studies. Methods DBA2/J mice were exposed to eight flurothyl-induced seizures (1/day) followed by 24-hour video-electroencephalographic recordings for 28-days. Forebrain and brainstem seizure thresholds were determined in C57BL/6J and DBA/2J mice following one or eight flurothyl-induced seizures, or after eight flurothyl-induced seizures, a 28-day incubation period, and final flurothyl rechallenge. Results Similar to C57BL/6J mice, DBA2/J mice expressed spontaneous seizures. However, unlike C57BL/6J mice, DBA2/J mice continued to have spontaneous seizures without remission. Because DBA2/J mice do not express forebrain→brainstem seizures following flurothyl rechallenge after a 28-day incubation period, this indicated that spontaneous seizures were not sufficient for the evolution of forebrain→brainstem seizures. Therefore, we determined whether brainstem seizure thresholds were changing during this repeated-flurothyl model and whether this could account for the expression of forebrain→brainstem seizures. Brainstem seizure thresholds were not different between C57BL/6J and DBA/2J mice on day one or on the last induction seizure trial (day eight). However, brainstem seizure thresholds did differ significantly on flurothyl rechallenge (day 28) with DBA/2J mice showing no lowering of their brainstem seizure thresholds. Significance These results demonstrated that DBA/2J mice exposed to the repeated-flurothyl model develop spontaneous seizures without evidence of seizure

  17. Dissociation of spontaneous seizures and brainstem seizure thresholds in mice exposed to eight flurothyl-induced generalized seizures.

    PubMed

    Kadiyala, Sridhar B; Ferland, Russell J

    2017-03-01

    C57BL/6J mice exposed to eight flurothyl-induced generalized clonic seizures exhibit a change in seizure phenotype following a 28-day incubation period and subsequent flurothyl rechallenge. Mice now develop a complex seizure semiology originating in the forebrain and propagating into the brainstem seizure network (a forebrain→brainstem seizure). In contrast, this phenotype change does not occur in seizure-sensitive DBA/2J mice. The underlying mechanism(s) was the focus of these studies. DBA2/J mice were exposed to eight flurothyl-induced seizures (1/day) followed by 24-hour video-electroencephalographic recordings for 28-days. Forebrain and brainstem seizure thresholds were determined in C57BL/6J and DBA/2J mice following one or eight flurothyl-induced seizures, or after eight flurothyl-induced seizures, a 28-day incubation period, and final flurothyl rechallenge. Similar to C57BL/6J mice, DBA2/J mice expressed spontaneous seizures. However, unlike C57BL/6J mice, DBA2/J mice continued to have spontaneous seizures without remission. Because DBA2/J mice do not express forebrain→brainstem seizures following flurothyl rechallenge after a 28-day incubation period, this indicated that spontaneous seizures were not sufficient for the evolution of forebrain→brainstem seizures. Therefore, we determined whether brainstem seizure thresholds were changing during this repeated-flurothyl model and whether this could account for the expression of forebrain→brainstem seizures. Brainstem seizure thresholds were not different between C57BL/6J and DBA/2J mice on day one or on the last induction seizure trial (day eight). However, brainstem seizure thresholds did differ significantly on flurothyl rechallenge (day 28) with DBA/2J mice showing no lowering of their brainstem seizure thresholds. These results demonstrated that DBA/2J mice exposed to the repeated-flurothyl model develop spontaneous seizures without evidence of seizure remission and provide a new model of

  18. Serotonin neurones have anti-convulsant effects and reduce seizure-induced mortality

    PubMed Central

    Buchanan, Gordon F; Murray, Nicholas M; Hajek, Michael A; Richerson, George B

    2014-01-01

    Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in patients with refractory epilepsy. Defects in central control of breathing are important contributors to the pathophysiology of SUDEP, and serotonin (5-HT) system dysfunction may be involved. Here we examined the effect of 5-HT neurone elimination or 5-HT reduction on seizure risk and seizure-induced mortality. Adult Lmx1bf/f/p mice, which lack >99% of 5-HT neurones in the CNS, and littermate controls (Lmx1bf/f) were subjected to acute seizure induction by maximal electroshock (MES) or pilocarpine, variably including electroencephalography, electrocardiography, plethysmography, mechanical ventilation or pharmacological therapy. Lmx1bf/f/p mice had a lower seizure threshold and increased seizure-induced mortality. Breathing ceased during most seizures without recovery, whereas cardiac activity persisted for up to 9 min before terminal arrest. The mortality rate of mice of both genotypes was reduced by mechanical ventilation during the seizure or 5-HT2A receptor agonist pretreatment. The selective serotonin reuptake inhibitor citalopram reduced mortality of Lmx1bf/f but not of Lmx1bf/f/p mice. In C57BL/6N mice, reduction of 5-HT synthesis with para-chlorophenylalanine increased MES-induced seizure severity but not mortality. We conclude that 5-HT neurones raise seizure threshold and decrease seizure-related mortality. Death ensued from respiratory failure, followed by terminal asystole. Given that SUDEP often occurs in association with generalised seizures, some mechanisms causing death in our model might be shared with those leading to SUDEP. This model may help determine the relationship between seizures, 5-HT system dysfunction, breathing and death, which may lead to novel ways to prevent SUDEP. PMID:25107926

  19. Mouse repeated electroconvulsive seizure (ECS) does not reverse social stress effects but does induce behavioral and hippocampal changes relevant to electroconvulsive therapy (ECT) side-effects in the treatment of depression

    PubMed Central

    Sigrist, Hannes; Seifritz, Erich; Fikse, Lianne; Bosker, Fokko J.; Schoevers, Robert A.; Klein, Hans C.

    2017-01-01

    Electroconvulsive therapy (ECT) is an effective treatment for depression, but can have negative side effects including amnesia. The mechanisms of action underlying both the antidepressant and side effects of ECT are not well understood. An equivalent manipulation that is conducted in experimental animals is electroconvulsive seizure (ECS). Rodent studies have provided valuable insights into potential mechanisms underlying the antidepressant and side effects of ECT. However, relatively few studies have investigated the effects of ECS in animal models with a depression-relevant manipulation such as chronic stress. In the present study, mice were first exposed to chronic social stress (CSS) or a control procedure for 15 days followed by ECS or a sham procedure for 10 days. Behavioral effects were investigated using an auditory fear conditioning (learning) and expression (memory) test and a treadmill-running fatigue test. Thereafter, immunohistochemistry was conducted on brain material using the microglial marker Iba-1 and the cholinergic fibre marker ChAT. CSS did not increase fear learning and memory in the present experimental design; in both the control and CSS mice ECS reduced fear learning and fear memory expression. CSS induced the expected fatigue-like effect in the treadmill-running test; ECS induced increased fatigue in CSS and control mice. In CSS and control mice ECS induced inflammation in hippocampus in terms of increased expression of Iba-1 in radiatum of CA1 and CA3. CSS and ECS both reduced acetylcholine function in hippocampus as indicated by decreased expression of ChAT in several hippocampal sub-regions. Therefore, CSS increased fatigue and reduced hippocampal ChAT activity and, rather than reversing these effects, a repeated ECS regimen resulted in impaired fear learning-memory, increased fatigue, increased hippocampal Iba-1 expression, and decreased hippocampal ChAT expression. As such, the current model does not provide insights into the

  20. Seizures in the peripartum period: Epidemiology, diagnosis and management.

    PubMed

    Aya, A G M; Ondze, B; Ripart, J; Cuvillon, P

    2016-10-01

    The occurrence of seizures in the peripartum period is a rare but particularly challenging situation. Seizures in the peripartum period could result from three categories of conditions: first and most frequent is the exacerbation of a known pre-existing seizure disorder, mainly epilepsy. A therapeutic evaluation is needed; second is the new onset of seizures due to a non-pregnancy-related problem. An accurate diagnosis and a specific treatment are required; third is range of pregnancy-related conditions. The present review focuses on this third category, with a special attention to disorders occurring in the peripartum period. It is structured in two sections. The first section is a focus on eclampsia since, based on ICU admission data, it appears to be the leading cause of pregnancy-related seizures. Its epidemiology, pathophysiology, clinical diagnosis, neuro-imaging features and recommended management are reviewed. The efficacy and safety of the recommended regimens of MgSO4 therapy are discussed, as well as controversies on the alteration of these regimens and the use of MgSO4 in women with mild preeclampsia. In the second section, the other causes of pregnancy-related new onset seizures are summarized. These include posterior reversible encephalopathy syndrome, reversible cerebral vasoconstriction syndrome, cerebral venous sinus thrombosis, thrombotic thrombocytopenic purpura, amniotic fluid embolism, and air embolism. Noteworthy is the fact that most of these pregnancy-related seizure conditions overlap with each other, mainly in terms of clinical presentations and neuro-imaging. Therefore, the diagnosis and the treatment options should be considered on a multidisciplinary basis.

  1. 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

  2. Maternal knowledge of acute seizures.

    PubMed

    Asiri, Nawal A; Bin Joubah, Mohammed A; Khan, Samar M; Jan, Mohammed M

    2015-10-01

    To study maternal knowledge -of, and behavior during acute seizures. A cross sectional study conducted from September 2013 to January 2014 included consecutive mothers presenting at the Pediatric Neurology Clinics of King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. A structured 30-item questionnaire was designed to examine their demographics, knowledge, and behavior on acute seizures. A total of 92 mothers were interviewed and 41% witnessed at least one acute seizure in their affected child (range 1-15 years, mean 4.5). Up to 26% felt not knowledgeable at all regarding the acute care and management of seizure. Mothers with higher education (college or university degree) were more likely to feel very knowledgeable (19% versus 11%, p=0.02). Only 10% were aware of an antiepileptic drug that could be used at home to stop prolonged seizures, and 35% mentioned that they would wait for 15 minutes before taking the child to the emergency department. Most mothers (93%) wanted more information. Those who felt strongly regarding that (66%), were more likely to be younger (<27 years) (p=0.01), and have at least 3 out of 7 mismanagement decisions (p=0.003). Maternal level of knowledge and behavior during acute seizures needs improvement. Many mothers have significant misinformation, negative behavior, and poor management practices. Increased awareness and educational programs are needed.

  3. Assimilating seizure dynamics.

    PubMed

    Ullah, Ghanim; Schiff, Steven J

    2010-05-06

    Observability of a dynamical system requires an understanding of its state-the collective values of its variables. However, existing techniques are too limited to measure all but a small fraction of the physical variables and parameters of neuronal networks. We constructed models of the biophysical properties of neuronal membrane, synaptic, and microenvironment dynamics, and incorporated them into a model-based predictor-controller framework from modern control theory. We demonstrate that it is now possible to meaningfully estimate the dynamics of small neuronal networks using as few as a single measured variable. Specifically, we assimilate noisy membrane potential measurements from individual hippocampal neurons to reconstruct the dynamics of networks of these cells, their extracellular microenvironment, and the activities of different neuronal types during seizures. We use reconstruction to account for unmeasured parts of the neuronal system, relating micro-domain metabolic processes to cellular excitability, and validate the reconstruction of cellular dynamical interactions against actual measurements. Data assimilation, the fusing of measurement with computational models, has significant potential to improve the way we observe and understand brain dynamics.

  4. Epilepsy (generalised seizures).

    PubMed

    Cross, J Helen

    2015-04-17

    About 3% of people will be diagnosed with epilepsy during their lifetime, but about 70% of people with epilepsy eventually go into remission. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of additional treatments in people with drug-resistant epilepsy characterised by generalised seizures? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found four studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety on the addition of the following interventions: lacosamide, lamotrigine, levetiracetam, perampanel, and zonisamide versus the addition of placebo.

  5. Chemical-genetic attenuation of focal neocortical seizures.

    PubMed

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

    2014-05-27

    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.

  6. Effects of cognitive processing therapy on PTSD-related negative cognitions in veterans with military sexual trauma.

    PubMed

    Holliday, Ryan; Link-Malcolm, Jessica; Morris, Elizabeth E; Surís, Alina

    2014-10-01

    Treating post-traumatic stress disorder (PTSD) related to military sexual trauma (MST) continues to be a priority in veteran populations. Because negative cognitions (NCs) contribute to PTSD severity and treatment, further understanding of how PTSD and related NCs can be addressed and changed within an MST sample is important. Our study analyzed 45 participants who received either cognitive processing therapy (n = 32) or present centered therapy (n = 13). Participants who received cognitive processing therapy had significantly lower NCs scores post-treatment and at follow-up sessions than participants in the present centered therapy condition (p < 0.05). In addition, NCs were positively correlated with PTSD severity (p < 0.05). Implications for future research are discussed for both MST-related and non-MST-related PTSD. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  7. Collaboration in Family Therapy

    PubMed Central

    Tuerk, Elena Hontoria; McCart, Michael R.; Henggeler, Scott W.

    2015-01-01

    This article summarizes and illustrates the collaboration strategies used by several family therapies. The strategies used within multisystemic therapy (MST) are emphasized because it has demonstrated high rates of treatment completion and favorable outcomes in multiple clinical trials. Many of the collaboration strategies in family work are common to other forms of evidence-based psychotherapy (e.g., reflective listening, empathy, reframing, and displays of authenticity and flexibility); however, some strategies are unique to family systems treatments, such as the identification of strengths across multiple systems in the youth’s social ecology and the maintenance of a family (versus a child) focus during treatment. A case example illustrates collaboration and engagement in the context of MST. PMID:23616297

  8. Epileptic Seizures From Abnormal Networks: Why Some Seizures Defy Predictability

    PubMed Central

    Azhar, Feraz; Kudela, Pawel; Bergey, Gregory K.; Franaszczuk, Piotr J.

    2011-01-01

    Summary Seizure prediction has proven to be difficult in clinically realistic environments. Is it possible that fluctuations in cortical firing could influence the onset of seizures in an ictal zone? To test this, we have now used neural network simulations in a computational model of cortex having a total of 65,536 neurons with intercellular wiring patterned after histological data. A spatially distributed Poisson driven background input representing the activity of neighboring cortex affected 1% of the neurons. Gamma distributions were fit to the interbursting phase intervals, a non-parametric test for randomness was applied, and a dynamical systems analysis was performed to search for period-1 orbits in the intervals. The non-parametric analysis suggests that intervals are being drawn at random from their underlying joint distribution and the dynamical systems analysis is consistent with a nondeterministic dynamical interpretation of the generation of bursting phases. These results imply that in a region of cortex with abnormal connectivity analogous to a seizure focus, it is possible to initiate seizure activity with fluctuations of input from the surrounding cortical regions. These findings suggest one possibility for ictal generation from abnormal focal epileptic networks. This mechanism additionally could help explain the difficulty in predicting partial seizures in some patients. PMID:22169211

  9. Epileptic seizures from abnormal networks: why some seizures defy predictability.

    PubMed

    Anderson, William S; Azhar, Feraz; Kudela, Pawel; Bergey, Gregory K; Franaszczuk, Piotr J

    2012-05-01

    Seizure prediction has proven to be difficult in clinically realistic environments. Is it possible that fluctuations in cortical firing could influence the onset of seizures in an ictal zone? To test this, we have now used neural network simulations in a computational model of cortex having a total of 65,536 neurons with intercellular wiring patterned after histological data. A spatially distributed Poisson driven background input representing the activity of neighboring cortex affected 1% of the neurons. Gamma distributions were fit to the interbursting phase intervals, a non-parametric test for randomness was applied, and a dynamical systems analysis was performed to search for period-1 orbits in the intervals. The non-parametric analysis suggests that intervals are being drawn at random from their underlying joint distribution and the dynamical systems analysis is consistent with a nondeterministic dynamical interpretation of the generation of bursting phases. These results imply that in a region of cortex with abnormal connectivity analogous to a seizure focus, it is possible to initiate seizure activity with fluctuations of input from the surrounding cortical regions. These findings suggest one possibility for ictal generation from abnormal focal epileptic networks. This mechanism additionally could help explain the difficulty in predicting partial seizures in some patients. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. [Oral loading dose of phenytoin in the treatment of serial seizures, prevention of seizure recurrence and rapid drug substitution].

    PubMed

    Sokić, D; Janković, S M

    1994-01-01

    Over a period of nine months twenty-five epileptic patients were treated with the oral loading dose of phenytoin. The dose ranged from 12 to 23 mg/kg body weight during 1 to 12 hours. In 20 patients with serial seizures or intolerance to other antiepileptic drugs this treatment was effective. Seizures also stopped in 2 of 4 patients with serial partial motor seizures. These 2 patients required both higher loading dose and faster rate of administration than the other patients. A patient with epilepsia partialis continua failed to respond to the treatment. Patients that received phenytoin through the naso-gastric tube, in respect to oral administration, required higher doses to obtain therapeutic plasma levels of phenytoin. One patient had mild nausea, 3 mild dizziness, and 1 tinitus on the first day of the treatment. There was no correlation between a given dose and the achieved phenytoin plasma levels. In our opinion the therapy with oral loading dose of phenytoin is highly effective in the treatment of serial generalized seizures and rapid antiepileptic drug substitution, and partially effective in the prevention of partial motor seizures. It produces only mild and transient side-effects.

  11. Seizures and Meperidine: Overstated and Underutilized.

    PubMed

    Schlick, Konrad H; Hemmen, Thomas M; Lyden, Patrick D

    2015-12-01

    Meperidine is used for pain control and treatment of shivering. Concerns about neurotoxicity, particularly seizures, have led to efforts limiting meperidine use. We reviewed the body of evidence linking meperidine to seizures. We searched PubMed for the terms meperidine, normeperidine, pethidine, and norpethidine; each was combined with the terms: seizure, epilepsy, epileptogenic, toxicity, overdose, seizure threshold, and convulsion. Articles were assessed for relevance. Semiologies were reviewed to ascertain seizure likelihood. Our search yielded 351 articles, of which 66 were relevant. Of these, 33 had primary clinical data on meperidine-associated seizures, comprising 50 patients. Twenty events were deemed likely to be seizures, 26 indeterminate, and 4 unlikely. Most studies were case reports. Confounding comorbidities were frequent. The evidence base for meperidine-associated seizures in man is scant. Seizure risk associated with meperidine appears to be overstated. The utility of meperidine should continue to be explored, especially for therapeutic hypothermia.

  12. Myocardial infarction following convulsive and nonconvulsive seizures.

    PubMed

    Montepietra, Sara; Cattaneo, Luigi; Granella, Franco; Maurizio, Annarita; Sasso, Enrico; Pavesi, Giovanni; Bortone, Ermelinda

    2009-06-01

    Myocardial infarction (MI) has been rarely reported in association with seizures, and only of convulsive type. We describe a series of five patients observed over a 4-year period, who presented MI immediately following seizures, either convulsive or nonconvulsive. Patient 1 had pre-existent coronary disease (CD) and presented multiple focal nonconvulsive seizures. Patient 2 had no CD, normal coronary angiography and presented secondary generalized convulsive seizures. Patient 3 had no history of CD, normal angiography and had a first single convulsive seizure. Patient 4 had severe CD and suffered from a single convulsive event. Patient 5 had a partial and a generalized seizure and had no known CD. MI following seizures is not an exceptional event and can occur in a spectrum of conditions including single or repeated, convulsive or nonconvulsive seizures, in patients with or without pre-existing coronary disease. We suggest that the occurrence of MI should be considered in epileptic patients during and shortly after seizures.

  13. Neurophysiological aspects of neonatal seizures.

    PubMed

    Watanabe, Kazuyoshi

    2014-05-01

    Recently, amplitude-integrated EEG (aEEG) has been increasingly used and proved useful in neonatal intensive care units (NICU) for the management of neonatal seizures. It does not replace, but is supplementary to standard EEG. This article reviews some of findings obtained with standard EEGs, and tries to interpret them with recent findings in the field of basic science. Seizures mainly occur in active-REM sleep in neonates. This is in sharp contrast to those in older children and adults, in whom epileptic seizures occur mainly in NREM sleep. This may be explained by neurotransmitter effects on sleep mechanisms of the neonatal brain that are different from those of older individuals. When all clinical seizures have no electrical correlates, they are non-epileptic, but when the correlation between clinical seizures and frequent electrical discharges are inconsistent, they should rather be considered epileptic, reflecting progression of status epilepticus causing electro-clinical dissociation. Electro-clinical dissociation is not a characteristic of neonatal seizures per se, but a feature of prolonged status epilepticus in adults as well as children. It occurs when prolonged status epilepticus itself causes a progressively severe encephalopathy, or when status occurs in the presence of a severe underlying encephalopathy. In neonates without pre-existing brain damage, frequent seizures per se may cause mild depression characterized by the loss of high voltage slow patterns, an important constituent of slow wave sleep reflecting cortico-cortical connectivity. Mild depression only in the acute stage is not associated with neurological sequelae, but previously damaged brain may be more vulnerable than normal brain.

  14. A mechanism of seizure induction by electricity and its clinical implications.

    PubMed

    Swartz, Conrad M

    2014-06-01

    A model of ECT seizure induction by rapid kindling is described. The electrical stimulus as a series of pulses progressively disrupts neuronal cell membranes, with corresponding progressive increases in intracellular concentrations of sodium, calcium, and voltage. Eventually, the intracellular voltage rises to trigger neuronal firing in waves from seizure foci. The quantity of seizure foci produced is expressed by the stimulus charge multiplied by the current cubed. Differences in implications are described between this model and the traditional model that extrapolates from an isolated single neuron undergoing immediate electrical depolarization by a single pulse. Total brain exposure to seizure neurotransmitter release in ECT is analogous to body exposure to medication in drug therapy and may be expressed by a physiological measurement such as electroencephalographic postictal suppression or peak seizure heart rate.

  15. Ketogenic diet in the treatment of seizures associated with hypothalamic hamartomas.

    PubMed

    Chapman, Kevin E; Kim, Do-Young; Rho, Jong M; Ng, Yu-Tze; Kerrigan, John F

    2011-05-01

    Seizures associated with hypothalamic hamartoma (HH) are notoriously intractable to medical therapy, and while surgical resection affords most affected patients with complete or near seizure-freedom, there remains a need to identify alternative treatments. In this retrospective study, we identified six patients from a large cohort of 220 patients with HH who were treated with the ketogenic diet (KD). Four patients had a 50-90% reduction in multiple seizure types (including gelastic, partial-onset and atonic seizures), and two individuals failed to respond. In order to study possible mechanisms, we then performed microelectrode recordings of small neurons in surgically resected HH tissue slices. Exposure to ketone bodies decreased spontaneous firing in 5 of 7 small HH neurons. These preliminary results suggest that seizures associated with HH may respond favorably to the KD, and that ketone bodies might directly modulate the intrinsic epileptogenicity of HH tissue.

  16. Silent seizures in sick infants in early life. Diagnosis by continuous cerebral function monitoring.

    PubMed

    Hellström-Westas, L; Rosén, I; Swenningsen, N W

    1985-09-01

    Cerebral electric activity was surveilled with a Cerebral Function Monitor (CFM) technique in 87 newborn infants under neonatal intensive care. A total of 26 infants had electrographical signs of repeated seizure activity. Among these infants 14 had periods of one hour or more of silent seizures activity. Among these infants 14 had periods of one hour or more of silent seizures, i.e. typical pattern of ictal epileptic activity on CFM without clinical symptoms or signs of convulsions. The occurrence of silent seizures and their pattern in relation to the clinical condition and management was unpredictable in most cases. Besides general limpness or flaccidity in an outward quiet baby these infants showed no clinical fits or clonic convulsions. The findings indicate that anticonvulsive therapy in small infants may be insufficient and need re-evaluation, since the long-term effect of silent seizures on cerebral function and activity is still uncertain.

  17. [Martin Luther's seizure disorder].

    PubMed

    Feldmann, H

    1989-01-01

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

  18. Regulation of emotions in psychogenic nonepileptic seizures.

    PubMed

    Urbanek, Monika; Harvey, Martin; McGowan, John; Agrawal, Niruj

    2014-08-01

    Despite the long history of psychogenic nonepileptic seizures (PNES), relatively little is known about the mechanisms that cause and maintain this condition. Emerging research evidence suggests that patients with PNES might have difficulties in regulating their emotions. However, much remains to be learned about the nature of these difficulties and the emotional responses of individuals with PNES. This study aimed to gain a detailed understanding of emotion regulation processes in patients with PNES by examining differences between patients with PNES and a healthy control group with regard to intensity of emotional reactions, understanding of one's emotional experience, beliefs about emotions, and managing emotions by controlling emotional expression. A cross-sectional design was used to compare the group with PNES (n=56) and the healthy control group (n=88) on a range of self-report measures. Participants with a diagnosis of PNES reported significantly poorer understanding of their emotions, more negative beliefs about emotions, and a greater tendency to control emotional expression compared to the control group. While intensity of emotions did not discriminate between the groups, poor understanding and negative beliefs about emotions were found to be significant predictors of PNES, even after controlling for age, education level, and emotional distress. Furthermore, the presence of some emotion regulation difficulties was associated with self-reported seizure severity. The results of this study are largely consistent with previous literature and provide evidence for difficulties in emotion regulation in patients with PNES. However, this research goes further in bringing together different aspects of emotion regulation, including beliefs about emotions, which have not been examined before. As far as it is known, this is the first study to suggest that levels of alexithymia in a population with PNES are positively associated with self-reported seizure severity. The

  19. Risk of seizure recurrence after achieving initial seizure freedom on the ketogenic diet.

    PubMed

    Taub, Katherine S; Kessler, Sudha Kilaru; Bergqvist, A G Christina

    2014-04-01

    Few studies have examined the long-term sustainability of complete seizure freedom on the ketogenic diet (KD). The purpose of this study was to describe the risk of seizure recurrence in children who achieved at least 1 month of seizure freedom on the KD, and to assess clinical features associated with sustained seizure freedom. Records of patients initiated on the KD at The Children's Hospital of Philadelphia (CHOP) from 1991 to 2009 were reviewed. Subjects who attained seizure freedom for at least 1 month within 2 years were included in the study. Seizure frequency was recorded based on caregiver-reported seizure diaries as unchanged, improved, or worse compared to baseline. Those patients with seizure freedom ≥1 year were compared to those with seizure freedom <1 year in terms of demographics, age of seizure onset, number of antiepileptic drugs (AEDs) prior to KD, and epilepsy classification. Of 276 patients initiated on the KD, 65 patients (24%) attained seizure freedom for a minimum of 1 month. The majority of these patients had daily seizures. The median time to seizure freedom after KD initiation was 1.5 months. Seizures recurred in 53 patients (82%), with a median time to seizure recurrence of 3 months. However, seizure frequency after initial recurrence remained far less than baseline. No clinical features were identified as risk factors for seizure recurrence. Seizure recurrence on the KD after 1 month of seizure freedom most often occurred as occasional breakthrough seizures and not a return to baseline seizure frequency. This study provides evidence to support the continued use of the KD in patients with initial seizure freedom even after breakthrough seizures. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  20. Randomized controlled trial of traditional Chinese medicine (acupuncture and tuina) in cerebral palsy: part 1--any increase in seizure in integrated acupuncture and rehabilitation group versus rehabilitation group?

    PubMed

    Wu, Yun; Zou, Li-Ping; Han, Tong-Li; Zheng, Hua; Caspi, Opher; Wong, Virginia; Su, Yani; Shen, Kun-Ling

    2008-10-01

    The objective of this study was to observe for any change in baseline seizure frequency with acupuncture in children with cerebral palsy. A randomized controlled study was conducted: Group I consisted of integrated acupuncture, tuina, and rehabilitation (physiotherapy, occupational therapy, and hydrotherapy) for 12 weeks; and Group II consisted of rehabilitation (physiotherapy, occupational therapy, and hydrotherapy) for 12 weeks. After a washout period of 4 weeks, Group II then received acupuncture and tuina for 12 weeks. Each subject received 5 daily acupuncture sessions per week for 12 weeks (total = 60 sessions). All children were assessed for any change in seizure frequency during treatment. One hundred and sixteen (116) children were recruited and randomized into Group I (N = 58) and Group II (N = 58). Thirty-three (33) children withdrew (9 from Group I and 24 from Group II). Of the remaining 83 children, Group I consisted of 49 and Group II of 34 children. For baseline, 5 children (6%; 5/83) had seizures. During phase 1 (12 weeks) of integrative treatment and subsequent 4-week follow-up, 3 children in Group I had seizures. Among those 3 children with seizures, 1 child with prior history of recurrent febrile seizure had 3 more recurrent febrile seizures during acupuncture treatment and 2 children without any prior history of seizures had new-onset seizures (1 with 3 recurrent febrile seizures and 1 with afebrile seizure). For Group I, 2 children with epilepsy had no increase in seizure frequency during acupuncture treatment. For Group II during the phase 2 acupuncture period, none had increase in seizure frequency. In both groups, 4 of 5 children (80%; 2 in Group I and 2 in Group II) with seizures had no increase in seizure frequency during acupuncture treatment and follow-up. The risk of increasing seizure is not increased with acupuncture treatment for cerebral palsy.

  1. Intergenerational Transmission of Enhanced Seizure Susceptibility after Febrile Seizures.

    PubMed

    Wu, Dengchang; Feng, Bo; Dai, Yunjian; Wu, Xiaohua; Chen, Bin; Xu, Cenglin; Tang, Yangshun; Wang, Kang; Zhang, Shihong; Wang, Shuang; Luo, Benyan; Chen, Zhong

    2017-03-01

    Environmental exposure early in development plays a role in susceptibility to disease in later life. Here, we demonstrate that prolonged febrile seizures induced by exposure of rat pups to a hyperthermic environment enhance seizure susceptibility not only in these hyperthermia-treated rats but also in their future offspring, even if the offspring never experience febrile seizures. This transgenerational transmission was intensity-dependent and was mainly from mothers to their offspring. The transmission was associated with DNA methylation. Thus, our study supports a "Lamarckian"-like mechanism of pathogenesis and the crucial role of epigenetic factors in neurological conditions. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  2. Generalized versus partial reflex seizures: a review.

    PubMed

    Italiano, Domenico; Ferlazzo, Edoardo; Gasparini, Sara; Spina, Edoardo; Mondello, Stefania; Labate, Angelo; Gambardella, Antonio; Aguglia, Umberto

    2014-08-01

    In this review we assess our currently available knowledge about reflex seizures with special emphasis on the difference between "generalized" reflex seizures induced by visual stimuli, thinking, praxis and language tasks, and "focal" seizures induced by startle, eating, music, hot water, somatosensory stimuli and orgasm. We discuss in particular evidence from animal, clinical, neurophysiological and neuroimaging studies supporting the concept that "generalized" reflex seizures, usually occurring in the setting of IGE, should be considered as focal seizures with quick secondary generalization. We also review recent advances in genetic and therapeutic approach of reflex seizures. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. Adeno-Associated Viral Vector-Induced Overexpression of Neuropeptide Y Y2 Receptors in the Hippocampus Suppresses Seizures

    ERIC Educational Resources Information Center

    Woldbye, David P. D.; Angehagen, Mikael; Gotzsche, Casper R.; Elbrond-Bek, Heidi; Sorensen, Andreas T.; Christiansen, Soren H.; Olesen, Mikkel V.; Nikitidou, Litsa; Hansen, Thomas v. O.; Kanter-Schlifke, Irene; Kokaia, Merab

    2010-01-01

    Gene therapy using recombinant adeno-associated viral vectors overexpressing neuropeptide Y in the hippocampus exerts seizure-suppressant effects in rodent epilepsy models and is currently considered for clinical application in patients with intractable mesial temporal lobe epilepsy. Seizure suppression by neuropeptide Y in the hippocampus is…

  4. Adeno-Associated Viral Vector-Induced Overexpression of Neuropeptide Y Y2 Receptors in the Hippocampus Suppresses Seizures

    ERIC Educational Resources Information Center

    Woldbye, David P. D.; Angehagen, Mikael; Gotzsche, Casper R.; Elbrond-Bek, Heidi; Sorensen, Andreas T.; Christiansen, Soren H.; Olesen, Mikkel V.; Nikitidou, Litsa; Hansen, Thomas v. O.; Kanter-Schlifke, Irene; Kokaia, Merab

    2010-01-01

    Gene therapy using recombinant adeno-associated viral vectors overexpressing neuropeptide Y in the hippocampus exerts seizure-suppressant effects in rodent epilepsy models and is currently considered for clinical application in patients with intractable mesial temporal lobe epilepsy. Seizure suppression by neuropeptide Y in the hippocampus is…

  5. The economics of data acquisition computers for ST and MST radars

    NASA Technical Reports Server (NTRS)

    Watkins, B. J.

    1983-01-01

    Some low cost options for data acquisition computers for ST (stratosphere, troposphere) and MST (mesosphere, stratosphere, troposphere) are presented. The particular equipment discussed reflects choices made by the University of Alaska group but of course many other options exist. The low cost microprocessor and array processor approach presented here has several advantages because of its modularity. An inexpensive system may be configured for a minimum performance ST radar, whereas a multiprocessor and/or a multiarray processor system may be used for a higher performance MST radar. This modularity is important for a network of radars because the initial cost is minimized while future upgrades will still be possible at minimal expense. This modularity also aids in lowering the cost of software development because system expansions should rquire little software changes. The functions of the radar computer will be to obtain Doppler spectra in near real time with some minor analysis such as vector wind determination.

  6. Capabilities and limitations of the Jicamarca radar as an MST radar

    NASA Technical Reports Server (NTRS)

    Woodman, R. F.; Farley, D. T.

    1983-01-01

    The Jicamarca radar (Long. 76.52W, Lat. 11.56S), located at 20 km from Lima at approximately 500 meters over sea level, is surrounded by mountains which provide a good shield from man-made interference. The radio horizon goes from a few hundred meters, across the dry valley where it is located, to 15 km, along the valley in the direction of the continental divide. This limits the clutter to 15 km, except for one high peak at 21 km. It is the most equatorial of all existing MST radars. Its proximity to the Andes, makes its location unique for the study of lee waves and orographic-induced turbulence. Vertical as well as horizontal projections of MST velocities are obtained by simultaneously pointing with different sections of the antenna into three or four different directions. The transmitters, receivers, and systems for data acquisition, processing, and control are included.

  7. Semiological seizure classification of epileptic seizures in children admitted to video-EEG monitoring unit.

    PubMed

    Alan, Serdar; Yalnızoğlu, Dilek; Turanlı, Güzide; Karlı-Oğuz, Kader; Lay-Ergun, Eser; Söylemezoğlu, Figen; Akalan, Nejat; Topçu, Meral

    2015-01-01

    We aimed to determine seizure characteristics of pediatric patients with epilepsy, and evaluate if Semiological Seizure Classification (SSC) system is applicable in this cohort. We retrospectively studied 183 patients, aged between 3 months-18 years, admitted to the video-EEG monitoring unit (VEMU). Most patients suffered from intractable epilepsy with comorbidities, and had structural lesions. Seizures were classified based on ictal video-EEG recordings by using SSC system; 157 patients had only one seizure type, 26 had more than one seizure types. Overall 211 seizures and 373 semiologies were analyzed; 114 seizures (54%) had more than one semiological subtype. The most frequent semiology was motor seizures (78%), followed by dialeptic seizures (12%). The most common subtypes were simple motor seizures (49%); tonic seizures constituted (28.4%) of all semiologies. We conclude that SSC system is applicable for children with epilepsy admitted to VEMU; complementary EEG and imaging data are required for evaluation of patients with epilepsy.

  8. Automated seizure detection systems and their effectiveness for each type of seizure.

    PubMed

    Ulate-Campos, A; Coughlin, F; Gaínza-Lein, M; Fernández, I Sánchez; Pearl, P L; Loddenkemper, T

    2016-08-01

    Epilepsy affects almost 1% of the population and most of the approximately 20-30% of patients with refractory epilepsy have one or more seizures per month. Seizure detection devices allow an objective assessment of seizure frequency and a treatment tailored to the individual patient. A rapid recognition and treatment of seizures through closed-loop systems could potentially decrease morbidity and mortality in epilepsy. However, no single detection device can detect all seizure types. Therefore, the choice of a seizure detection device should consider the patient-specific seizure semiologies. This review of the literature evaluates seizure detection devices and their effectiveness for different seizure types. Our aim is to summarize current evidence, offer suggestions on how to select the most suitable seizure detection device for each patient and provide guidance to physicians, families and researchers when choosing or designing seizure detection devices. Further, this review will guide future prospective validation studies. Copyright © 2016. Published by Elsevier Ltd.

  9. Seizures in the critically ill.

    PubMed

    Ch'ang, J; Claassen, J

    2017-01-01

    Critically ill patients with seizures are either admitted to the intensive care unit because of uncontrolled seizures requiring aggressive treatment or are admitted for other reasons and develop seizures secondarily. These patients may have multiorgan failure and severe metabolic and electrolyte disarrangements, and may require complex medication regimens and interventions. Seizures can be seen as a result of an acute systemic illness, a primary neurologic pathology, or a medication side-effect and can present in a wide array of symptoms from convulsive activity, subtle twitching, to lethargy. In this population, untreated isolated seizures can quickly escalate to generalized convulsive status epilepticus or, more frequently, nonconvulsive status epileptics, which is associated with a high morbidity and mortality. Status epilepticus (SE) arises from a failure of inhibitory mechanisms and an enhancement of excitatory pathways causing permanent neuronal injury and other systemic sequelae. Carrying a high 30-day mortality rate, SE can be very difficult to treat in this complex setting, and a portion of these patients will become refractory, requiring narcotics and anesthetic medications. The most significant factor in successfully treating status epilepticus is initiating antiepileptic drugs as soon as possible, thus attentiveness and recognition of this disease are critical.

  10. Defective Leukocyte Adhesion and Chemotaxis Contributes to Combined Immunodeficiency in Humans with Autosomal Recessive MST1 Deficiency.

    PubMed

    Dang, Tarana Singh; Willet, Joseph D P; Griffin, Helen R; Morgan, Neil V; O'Boyle, Graeme; Arkwright, Peter D; Hughes, Stephen M; Abinun, Mario; Tee, Louise J; Barge, Dawn; Engelhardt, Karin R; Jackson, Michael; Cant, Andrew J; Maher, Eamonn R; Koref, Mauro Santibanez; Reynard, Louise N; Ali, Simi; Hambleton, Sophie

    2016-02-01

    To investigate the clinical and functional aspects of MST1 (STK4) deficiency in a profoundly CD4-lymphopenic kindred with a novel homozygous nonsense mutation in STK4. Although recent studies have described the cellular effects of murine Mst1 deficiency, the phenotype of MST1-deficient human lymphocytes has yet to be fully explored. Patient lymphocytes were therefore investigated in the context of current knowledge of murine Mst1 deficiency. Genetic etiology was identified by whole exome sequencing of genomic DNA from two siblings, combined with linkage analysis in the wider family. MST1 protein expression was assessed by immunoblotting. The ability of patient lymphocytes to adhere to ICAM-1 under flow conditions was measured, and transwell assays were used to assess chemotaxis. Chemokine receptor expression was examined by flow cytometry and receptor signalling by immunoblotting. A homozygous nonsense mutation in STK4 (c.442C > T, p.Arg148Stop) was found in the patients, leading to a lack of MST1 protein expression. Patient leukocytes exhibited deficient chemotaxis after stimulation with CXCL11, despite preserved expression of CXCR3. Patient lymphocytes were also unable to bind effectively to immobilised ICAM-1 under flow conditions, in keeping with a failure to develop high affinity binding. The observed abnormalities of adhesion and migration imply a profound trafficking defect among human MST1-deficient lymphocytes. By analogy with murine Mst1 deficiency and other defects of leucocyte trafficking, this is likely to contribute to immunodeficiency by impairing key aspects of T-cell development and function such as positive selection in the thymus, thymic egress and immune synapse formation in the periphery.

  11. 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.

  12. Modulation of visual signals in macaque MT and MST neurons during pursuit eye movement.

    PubMed

    Chukoskie, Leanne; Movshon, J Anthony

    2009-12-01

    Retinal image motion is produced with each eye movement, yet we usually do not perceive this self-produced "reafferent" motion, nor are motion judgments much impaired when the eyes move. To understand the neural mechanisms involved in processing reafferent motion and distinguishing it from the motion of objects in the world, we studied the visual responses of single cells in middle temporal (MT) and medial superior temporal (MST) areas during steady fixation and smooth-pursuit eye movements in awake, behaving macaques. We measured neuronal responses to random-dot patterns moving at different speeds in a stimulus window that moved with the pursuit target and the eyes. This allowed us to control retinal image motion at all eye velocities. We found the expected high proportion of cells selective for the direction of visual motion. Pursuit tracking changed both response amplitude and preferred retinal speed for some cells. The changes in preferred speed were on average weakly but systematically related to the speed of pursuit for area MST cells, as would be expected if the shifts in speed selectivity were compensating for reafferent input. In area MT, speed tuning did not change systematically during pursuit. Many cells in both areas also changed response amplitude during pursuit; the most common form of modulation was response suppression when pursuit was opposite in direction to the cell's preferred direction. These results suggest that some cells in area MST encode retinal image motion veridically during eye movements, whereas others in both MT and MST contribute to the suppression of visual responses to reafferent motion.

  13. Probing RFP Density Limits and the Interaction of Pellet Fueling and NBI Heating on MST

    NASA Astrophysics Data System (ADS)

    Caspary, K. J.; Chapman, B. E.; Anderson, J. K.; Limbach, S. T.; Oliva, S. P.; Sarff, J. S.; Waksman, J.; Combs, S. K.; Foust, C. R.

    2013-10-01

    Pellet fueling on MST has previously achieved Greenwald fractions of up to 1.5 in 200 kA improved confinement discharges. Additionally, pellet fueling to densities above the Greenwald limit in 200 kA standard discharges resulted in early termination of the plasma, but pellet size was insufficient to exceed the limit for higher current discharges. To this end, the pellet injector on MST has been upgraded to increase the maximum fueling capability by increasing the size of the pellet guide tubes, which constrain the lateral motion of the pellet in flight, to accommodate pellets of up to 4.0 mm in diameter. These 4.0 mm pellets are capable of triggering density limit terminations for MST's peak current of 600 kA. An unexpected improvement in the pellet speed and mass control was also observed compared to the smaller diameter pellets. Exploring the effect of increased density on NBI particle and heat deposition shows that for MST's 1 MW tangential NBI, core deposition of 25 keV neutrals is optimized for densities of 2-3 × 1019 m-3. This is key for beta limit studies in pellet fueled discharges with improved confinement where maximum NBI heating is desired. An observed toroidal deflection of pellets injected into NBI heated discharges is consistent with asymmetric ablation due to the fast ion population. In 200 kA improved confinement plasmas with NBI heating, pellet fueling has achieved a Greenwald fraction of 2.0. Work supported by US DoE.

  14. Increase in MST activity correlates with visual motion learning: A functional MRI study of perceptual learning.

    PubMed

    Larcombe, Stephanie J; Kennard, Chris; Bridge, Holly

    2017-09-30

    Repeated practice of a specific task can improve visual performance, but the neural mechanisms underlying this improvement in performance are not yet well understood. Here we trained healthy participants on a visual motion task daily for 5 days in one visual hemifield. Before and after training, we used functional magnetic resonance imaging (fMRI) to measure the change in neural activity. We also imaged a control group of participants on two occasions who did not receive any task training. While in the MRI scanner, all participants completed the motion task in the trained and untrained visual hemifields separately. Following training, participants improved their ability to discriminate motion direction in the trained hemifield and, to a lesser extent, in the untrained hemifield. The amount of task learning correlated positively with the change in activity in the medial superior temporal (MST) area. MST is the anterior portion of the human motion complex (hMT+). MST changes were localized to the hemisphere contralateral to the region of the visual field, where perceptual training was delivered. Visual areas V2 and V3a showed an increase in activity between the first and second scan in the training group, but this was not correlated with performance. The contralateral anterior hippocampus and bilateral dorsolateral prefrontal cortex (DLPFC) and frontal pole showed changes in neural activity that also correlated with the amount of task learning. These findings emphasize the importance of MST in perceptual learning of a visual motion task. Hum Brain Mapp, 2017. © 2017 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. © 2017 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

  15. A note on the use of coherent integration in periodogram analysis of MST radar signals

    NASA Technical Reports Server (NTRS)

    Rastogi, P. K.

    1983-01-01

    The effect of coherent integration on the periodogram method to estimate the power spectra of MST radar signals is examined. The spectrum estimate usually is biased, even when care is taken to reduce the aliasing effects. Due to this bias, the signal power for Doppler shifted signals is underestimated by as much as 4 dB. The use of coherent integration in reducing the effect of aliased power line harmonics is pointed out.

  16. Clinical characteristics of children with febrile seizure.

    PubMed

    Shrestha, D; Dhakal, A K; Shakya, H; Shakya, A; Shah, S C; Mehata, S

    2014-01-01

    Febrile seizure is common in children below five years of age. This study was conducted to evaluate the clinical profile of children presenting with febrile seizure in a teaching hospital. This was a descriptive retrospective study among children presenting with febrile seizure in a teaching hospital from July 2009 to June 2013. Children between six months to six years were included in the study while patients with prior episodes of afebrile seizures, abnormal neurodevelopment and not meeting the age criteria were excluded. Patient's demographic and clinical data were collected from the in-patients records and analyzed. This study included 103 children with febrile seizure. Out of which 67% were male. Simple febrile seizure and complex febrile seizure were observed in 76.7% and 23.3% of patients respectively. Majority of children (71.8%)had generalized tonic clonic seizure followed by tonic seizures. Most of children (72.8%) who developed first episode of seizure were below 24 months of age with the mean age of 20.7 (±12.1) months. Overall 33% of patients developed recurrence of febrile seizure and first episode of febrile seizure at age one year or below was associated with the seizure recurrence. Upper respiratory tract infections were the commonest cause of fever in these children. Febrile seizure was observed predominantly in children below age of two years and simple febrile seizure was the ommonest variety. Recurrence of febrile seizure was common and significantly associated with the first episode of febrile seizure at the age of one year or below.

  17. The MST3/STK24 kinase mediates impaired fasting blood glucose after a high-fat diet.

    PubMed

    Iglesias, Cristina; Floridia, Ebel; Sartages, Miriam; Porteiro, Begoña; Fraile, María; Guerrero, Ana; Santos, Diana; Cuñarro, Juan; Tovar, Sulay; Nogueiras, Rubén; Pombo, Celia M; Zalvide, Juan

    2017-09-27

    The identification of mediators in the pathogenesis of type 2 diabetes mellitus is essential for the full understanding of this disease. Protein kinases are especially important because of their potential as pharmacological targets. The goal of this study was to investigate whether mammalian sterile-20 3 (MST3/STK24), a stress-regulated kinase, is involved in metabolic alterations in obesity. Glucose regulation of Mst3 (also known as Stk24)-knockout mice was analysed both in 129;C57 mixed background mice and in C57/BL6J mice fed normally or with a high-fat diet (HFD). This work was complemented with an analysis of the insulin signalling pathway in cultured human liver cells made deficient in MST3 using RNA interference. MST3 is phosphorylated in the livers of mice subject to an obesity-promoting HFD, and its deficiency lowers the hyperglycaemia, hyperinsulinaemia and insulin resistance that the animals develop with this diet, an effect that is seen even without complete inactivation of the kinase. Lack of MST3 results in activation of the insulin signalling pathway downstream of IRS1, in both cultured liver cells and the liver of animals after HFD. This effect increases the inhibition of forkhead box (FOX)O1, with subsequent downregulation of the expression of gluconeogenic enzymes. MST3 inhibits the insulin signalling pathway and is important in the development of insulin resistance and impaired blood glucose levels after an HFD.

  18. Varying seizure semiology according to age.

    PubMed

    Nordli, Douglas R

    2013-01-01

    The clinical manifestations of seizures change in a predictable fashion with advancing age. For focal seizures these changes can be summarized into domains similar to those used in developmental models. These include fine motor, communication, and gross motor manifestations. Instead of socialization the fourth domain for seizure semiology concerns synchronization. Focal seizures in the very young tend to be simpler with fewer fine motor manifestations. Auras are uncommon, even in young children with some linguistic skill and it is often difficult to discern alteration of consciousness. Infantile focal seizures can present with spasms or even diffuse tonic seizures. In terms of synchronization, orderly secondary generalization is rarely seen so that primary generalized clonic seizures are rarely recorded in infants. Amongst so-called "generalized" seizures spasms are most often seen in the first year of life. Absence seizures, myoclonic-astatic and generalized tonic-clonic seizures are all usually not seen until after age 2 years. A full description of the clinical details of seizures is probably the most important part of the epilepsy history. A detailed knowledge of seizure semiology can make the history more effective and also in the identification of the correct seizure classification. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Intraoperative seizures during craniotomy under general anesthesia.

    PubMed

    Howe, John; Lu, Xiaoying; Thompson, Zoe; Peterson, Gordon W; Losey, Travis E

    2016-05-01

    An acute symptomatic seizure is a clinical seizure occurring at the time of or in close temporal association with a brain insult. We report an acute symptomatic seizure occurring during a surgical procedure in a patient who did not have a prior history of epilepsy and who did not have a lesion associated with an increased risk of epilepsy. To characterize the incidence and clinical features of intraoperative seizures during craniotomy under general anesthesia, we reviewed cases where continuous EEG was acquired during craniotomy. Records of 400 consecutive cases with propofol as general anesthesia during craniotomy were reviewed. Demographic data, indication for surgery, clinical history, history of prior seizures, duration of surgery and duration of burst suppression were recorded. Cases where seizures were observed were analyzed in detail. Two out of 400 patients experienced intraoperative seizures, including one patient who appeared to have an acute symptomatic seizure related to the surgical procedure itself and a second patient who experienced two seizures likely related to an underlying diagnosis of epilepsy. This is the first report of an acute symptomatic seizure secondary to a neurosurgical procedure. Overall, 0.5% of patients monitored experienced seizures, indicating that intraoperative seizures are rare, and EEG monitoring during craniotomies is of low yield in detecting seizures. Copyright © 2016. Published by Elsevier Ltd.

  20. Parametric dependence and inductive control of 3D helical equilibria in the MST RFP

    NASA Astrophysics Data System (ADS)

    Chapman, B. E.; den Hartog, D. J.; Kumar, S. T. A.; Nornberg, M.; Parke, E.; Reusch, J. A.; Cappello, S.; Franz, P.; Piovesan, P.; Puiatti, M.; Spolaore, M.; Brower, D. L.; Ding, W. X.; Lin, L.

    2012-10-01

    A stellarator-like equilibrium emerges in the core of RFP plasmas when the innermost resonant m = 1 tearing mode grows to large amplitude and the other, secondary m = 1 mode amplitudes are reduced. In MST, the likelihood and duration of these quasi-single-helicity (QSH) spectra increase strongly with Ip, similar to the trend observed in RFX-mod RFP plasmas which also develop a helical equilibrium. However, the Ip at which these spectra emerge in MST is nearly three times smaller than in RFX-mod. But due to additional differences in Te, Zeff, majority ion mass, and density, the two dev