MedWorm: Epilepsy

Health utility after emergency medical admission: A cross-sectional survey

Health and Quality of Life Outcomes — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions: Health utility can be measured after emergency medical admission, although responder bias may be significant. Health utility after emergency medical admission is poor compared to population norms. We have identified independent predictors or health utility that need to be measured and taken into account in non-randomized evaluations of emergency care. (Source: Health and Quality of Life Outcomes)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Editorial Board

Seizure: European Journal of Epilepsy — Fri, 03 Feb 2012 01:29:33 +0100

(Source: Seizure: European Journal of Epilepsy)

The neurologic findings in Taybi–Linder syndrome (MOPD I/III): Case report and review of the literature

American Journal of Medical Genetics Part A — Thu, 02 Feb 2012 05:00:00 +0100

We present two siblings with Taybi–Linder syndrome, with an emphasis on the neurological profile in this disease, which includes brain malformations, intractable epilepsy, sensory deficits, profound cognitive deficits, and neuroendocrine dysfunction. We also present distinctive correlative neuroimaging (MRI) and electroencephalographic (EEG) findings. Increased knowledge of the neurological profile of Taybi–Linder syndrome may be helpful for clinicians and genetic counselors managing these patients. © 2012 Wiley Periodicals, Inc. (Source: American Journal of Medical Genetics Part A)

Risk for attempted suicide in children and youths after contact with somatic hospitals: a Danish register based nested case-control study

Journal of Epidemiology and Community Health — Thu, 02 Feb 2012 05:00:00 +0100

Conclusions Based on the results of the study a strategy to minimise the risk of attempted suicide among children and youths must be implemented. The strategy should mainly focus on children at high risk—that is, children from families with low socioeconomic status, and children with a psychiatric history, a history of previous suicide attempts and with an unstable somatic disease subsequently causing many admissions. (Source: Journal of Epidemiology and Community Health)

Certain Neurons Respond Specifically to Animals

Scientific American - Official RSS Feed — Wed, 01 Feb 2012 13:00:00 +0100

Whether cute and cuddly or fierce and frightening, animals affect the brain in ways scientists are just starting to appreciate. In a study of people who had electrodes implanted in their brain for the treatment of epilepsy, an international team discovered neurons that respond specifically to animals. The 41 individuals in the study were shown picturesof recognizable landmarks, objects, animals and people for about one second each as tiny electrodes measured the activity of individual neurons in three regions of their brain. When the researchers analyzed the electrical data from the 400 to 550 neurons in each region, they found a marked jump in the activity of neurons in the right amygdala that was not seen in the other brain regions tested--and only after viewing the pictures of animals. ...

Seizure risk increased before and after psychiatric hospitalization

MedWire News - Bipolar Disorder — Wed, 01 Feb 2012 10:50:57 +0100

Results from a Swedish study suggest the risk for unprovoked epileptic seizures is significantly increased before and after hospitalization for psychiatric disorders. (Source: MedWire News - Bipolar Disorder)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Secrets of the inner voice unlocked

NHS News Feed — Wed, 01 Feb 2012 10:19:00 +0100

Conclusion This study of 15 people undergoing brain surgery has demonstrated a method of reconstructing the sound of a heard word using only the signals obtained from the brain. This study represents an important progression in the field of speech reconstruction, which has the potential to improve the lives of many who suffer from speech difficulties in the future. But the words, when reconstructed, were not of good enough quality to be recognised by a human listener when played. The words could only be identified when the original and reconstructed sound patterns were compared visually. The researchers suggest that improving the brain sensors detecting the STG brain activity may, in the future, improve the reconstructed sound to a level that could be understood by a person listening. The ...

Identification of new epilepsy treatments: Issues in preclinical methodology

Epilepsia — Wed, 01 Feb 2012 05:00:00 +0100

SummaryPreclinical research has facilitated the discovery of valuable drugs for the symptomatic treatment of epilepsy. Yet, despite these therapies, seizures are not adequately controlled in a third of all affected individuals, and comorbidities still impose a major burden on quality of life. The introduction of multiple new therapies into clinical use over the past two decades has done little to change this. There is an urgent demand to address the unmet clinical needs for: (1) new symptomatic antiseizure treatments for drug‐resistant seizures with improved efficacy/tolerability profiles, (2) disease‐modifying treatments that prevent or ameliorate the process of epileptogenesis, and (3) treatments for the common comorbidities that contribute to disability in people with epilepsy. New ...

Revising the “Rule of Three” for inferring seizure freedom

Epilepsia — Wed, 01 Feb 2012 05:00:00 +0100

SummaryPurpose: How long after starting a new medication must a patient go without seizures before they can be regarded as seizure‐free? A recent International League Against Epilepsy (ILAE) task force proposed using a “Rule of Three” as an operational definition of seizure freedom, according to which a patient should be considered seizure‐free following an intervention after a period without seizures has elapsed equal to three times the longest preintervention interseizure interval over the previous year. This rule was motivated in large part by statistical considerations advanced in a classic 1983 paper by Hanley and Lippman‐Hand. However, strict adherence to the statistical logic of this rule generally requires waiting much longer than recommended by the ILAE task force. Th...

Brainstem lesions and epilepsy

Epilepsia — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Epilepsia)

Blocking seizures with the diuretic bumetanide: Promises and pitfalls

Epilepsia — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Epilepsia)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Announcements

Epilepsia — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Epilepsia)

Erratum

Epilepsia — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Epilepsia)

Synergistic effects of CNS‐directed gene therapy and bone marrow transplantation in the murine model of infantile neuronal ceroid lipofuscinosis

Annals of Neurology — Wed, 01 Feb 2012 05:00:00 +0100

AbstractObjective:Infantile neuronal ceroid lipofusciniosis (INCL) is an inherited childhood neurodegenerative disorder caused by the loss of palmitoyl protein thioesterase‐1 (PPT1) activity. Affected children suffer from blindness, epilepsy, motor dysfunction, cognitive decline, and premature death. The Ppt1‐/‐ mouse shares the histological and clinical features of INCL. Previous single‐therapy approaches using small molecule drugs, gene therapy, or neuronal stem cells resulted in partial histological correction, with minimal improvements in motor function or lifespan. Here, we combined CNS‐directed AAV2/5‐mediated gene therapy with bone marrow transplantation (BMT) in the INCL mouse.Methods:At birth, Ppt1‐/‐ and WT mice were given either intracranial injections of AAV2/5�...

Changes in interictal spike features precede the onset of temporal lobe epilepsy

Annals of Neurology — Wed, 01 Feb 2012 05:00:00 +0100

AbstractObjective.One cornerstone event during epileptogenesis is the occurrence of the first spontaneous seizure (SZ1). It is therefore important to identify biomarkers of the network alterations leading to SZ1. In experimental models of temporal lobe epilepsy (TLE), interictal‐like activity (ILA) precedes SZ1 by several days. The goal of this study was to determine whether ILA dynamics bore electrophysiological features signing the impeding transition to SZ1.Methods.Experimental TLE was triggered by pilocarpine‐ or kainic acid‐induced status epilepticus (SE). Continuous EEG recordings were performed 7 days before and up to 40 days after SE. The amplitude and duration of the spike and wave components of interictal spikes were analyzed.Results.Two types of interictal spikes were dist...

Editorial Board

Epilepsy Research — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Epilepsy Research)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

A National Profile of Childhood Epilepsy and Seizure Disorder

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

Epilepsy/seizure disorder is known to be associated with a range of mental health and neurodevelopmental comorbidities, based on clinical studies, and on population studies largely conducted outside the United States. In a nationally representative sample of US children, estimated prevalence of reported lifetime epilepsy/seizure disorder was 1%, and of current epilepsy/seizure disorder was 6.3/1000. Developmental, mental health, and physical comorbidities are common, warranting enhanced surveillance, and an integrated service approach. (Read the full article) (Source: PEDIATRICS)

Co-occurring Conditions and Change in Diagnosis in Autism Spectrum Disorders

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: These findings suggest that the presence of co-occurring psychiatric and neurodevelopmental conditions are associated with a change in ASD diagnosis. Questions remain as to whether changes in diagnosis of an ASD are due to true etiologic differences or shifts in diagnostic determination. (Source: PEDIATRICS)

Successful Treatment of Type 1 Diabetes and Seizures With Combined Ketogenic Diet and Insulin

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

We report the case of a 2-year-old girl who presented to the emergency department with 1-week history of decreased activity, polyuria, and decreased oral intake. Her past medical history was remarkable for epilepsy, for which she was started on the KD with a significant improvement. Her laboratory evaluation was compatible with DKA, and fluids and insulin were given until correction. Because of concerns regarding recurrence of her seizures, the KD was resumed along with the simultaneous use of insulin glargine and insulin aspart. Urine ketones were kept in the moderate range to keep the effect of ketosis on seizure control. Under this combined therapy, the patient remained seizure-free with no new episodes of DKA. (Source: PEDIATRICS)

Levetiracetam has an activity‐dependent effect on inhibitory transmission

Epilepsia — Tue, 31 Jan 2012 05:00:00 +0100

SummaryPurpose: Previous work has shown that levetiracetam (LEV) binds the vesicular protein SV2A and reduces excitatory neurotransmitter release during trains of high‐frequency activity, most likely by accessing its binding site through vesicular endocytosis into excitatory synaptic terminals. Because there are differences in excitatory and inhibitory transmitter release mechanisms, and there are suggestions that neurons differ in their SV2A expression, we were curious whether LEV also reduces inhibitory transmission.Methods: We used patch‐clamp recording from CA1 neurons in rat brain slices to quantify the effects of LEV on inhibitory postsynaptic currents (IPSCs). We were able to elicit pure IPSCs by stimulating inhibitory terminals close to neuronal soma and blocking excitato...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Coexistence of schizophrenia and epilepsy: Record‐linkage studies

Epilepsia — Tue, 31 Jan 2012 05:00:00 +0100

SummaryFor many years, there has been interest in a possible link between epilepsy and schizophrenia. A recent study found a strong, bidirectional link between the two conditions: people with one had a higher than average risk of having the other. Using two large data sets of hospital admission data, we investigated whether schizophrenia and epilepsy occur together in individuals more commonly than expected by chance. We undertook a retrospective cohort study using the Oxford Record Linkage Study (ORLS) and English national linked Hospital Episode Statistics to investigate the coexistence of these conditions. There was an elevated risk of epilepsy in people admitted to hospital with schizophrenia (ORLS rate ratio 2.1, 95% confidence interval 1.6–2.6; England 3.0, 2.9–3.1) and an elevat...

A thermoprotective role of the sodium channel β1 subunit is lost with the β1(C121W) mutation

Epilepsia — Tue, 31 Jan 2012 05:00:00 +0100

SummaryPurpose: A mutation in the β1 subunit of the voltage‐gated sodium (NaV) channel, β1(C121W), causes genetic epilepsy with febrile seizures plus (GEFS+), a pediatric syndrome in which febrile seizures are the predominant phenotype. Previous studies of molecular mechanisms underlying neuronal hyperexcitability caused by this mutation were conducted at room temperature. The prevalence of seizures during febrile states in patients with GEFS+, however, suggests that the phenotypic consequence of β1(C121W) may be exacerbated by elevated temperature. We investigated the putative mechanism underlying seizure generation by the β1(C121W) mutation with elevated temperature.Methods: Whole‐cell voltage clamp experiments were performed at 22 and 34°C using Chinese Hamster Ovary (CHO...

Cooling of the epileptic focus suppresses seizures with minimal influence on neurologic functions

Epilepsia — Tue, 31 Jan 2012 05:00:00 +0100

SummaryPurpose: Focal brain cooling is effective for suppression of epileptic seizures, but it is unclear if seizures can be suppressed without a substantial influence on normal neurologic function. To address the issue, a thermoelectrically driven cooling system was developed and applied in free‐moving rat models of focal seizure and epilepsy.Methods: Focal seizures limited to the unilateral forelimb were induced by local application of a penicillin G solution or cobalt powder to the unilateral sensorimotor cortex. A proportional integration and differentiation (PID)–controlled, thermoelectrically driven cooling device (weight of 11 g) and bipolar electrodes were chronically implanted on the eloquent area (on the epileptic focus) and the effects of cooling (20, 15, and 10°C) ...

Prevalence case‐control study of epilepsy in three Burkina Faso villages

Acta Neurologica Scandinavica — Tue, 31 Jan 2012 05:00:00 +0100

DiscussionSeveral factors were associated with prevalent epilepsy, with Ag‐ELISA suggesting the presence of neurocysticercosis. The association between epilepsy and some occupations may reflect differences in local attitudes toward epilepsy and should be further explored. (Source: Acta Neurologica Scandinavica)

A new trick of INPP4A: Decreased expression of INPP4A in patients with temporal lobe epilepsy and pilocarpine‐induced rat model

Synapse — Tue, 31 Jan 2012 05:00:00 +0100

AbstractInositol polyphosphate phosphatase 4 A (INPP4A), a phosphoinositides phosphatase, is highly expressed in the central nervous system and plays a role in glutamate excitotoxicity and cell proliferation. Our aim was to investigate the expression of INPP4A in patients with temporal lobe epilepsy (TLE) and in a rat model of epilepsy. We assessed the expression of INPP4A in the temporal neocortex from twenty TLE patients. The result showed that INPP4A expression was significantly lower in TLE patients than in controls. To validate the results found in TLE patients, we assessed the expression of INPP4A in rat model. Rat epilepsy was induced by lithium‐pilocarpine. Expression of INPP4A of rat models was assessed by immunohistochemistry, immunofluorescence and Western blotting. INPP4A was...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Homeobox gene distal-less is required for neuronal differentiation and neurite outgrowth in the Drosophila olfactory system [Developmental Biology]

Proceedings of the National Academy of Sciences — Tue, 31 Jan 2012 05:00:00 +0100

Vertebrate Dlx genes have been implicated in the differentiation of multiple neuronal subtypes, including cortical GABAergic interneurons, and mutations in Dlx genes have been linked to clinical conditions such as epilepsy and autism. Here we show that the single Drosophila Dlx homolog, distal-less, is required both to specify chemosensory neurons and to regulate the morphologies of their axons and dendrites. We establish that distal-less is necessary for development of the mushroom body, a brain region that processes olfactory information. These are important examples of distal-less function in an invertebrate nervous system and demonstrate that the Drosophila larval olfactory system is a powerful model in which to understand distal-less functions during neurogenesis. (Source: Proceedings...

Aurora A is differentially expressed in gliomas, is associated with patient survival in glioblastoma and is a potential chemotherapeutic target in gliomas.

Cell Cycle — Mon, 30 Jan 2012 08:36:21 +0100

Authors: Lehman NL, O'Donnell JP, Whiteley LJ, Stapp RT, Lehman TD, Roszka KM, Schultz LR, Williams CJ, Mikkelsen T, Brown SL, Ecsedy JA, Poisson LM Abstract Aurora A is critical for mitosis and is overexpressed in several neoplasms. Its overexpression transforms cultured cells, and both its overexpression and knockdown cause genomic instability. In transgenic mice, Aurora A haploinsufficiency, not overexpression, leads to increased malignant tumor formation. Aurora A thus appears to have both tumor-promoting and tumor-suppressor functions. Here, we report that Aurora A protein, measured by quantitative protein gel blotting, is differentially expressed in major glioma types in lineage-specific patterns. Aurora A protein levels in WHO grade II oligodendrogliomas (n = 16) and grade I...

Cerebral Abscesses in Behcet's Disease: A Case Report.

Turkish Neurosurgery — Mon, 30 Jan 2012 05:00:02 +0100

Authors: Tokgoz S, Ogmegul A, Mutluer M, Kivrak AS, Ustun ME Abstract Behçet's disease is a multisystem relapsing inflammatory disorder of unknown cause. Neurological involvement is one of the most serious causes of long-term morbidity and mortality in Behçet's disease. Cerebral abscess is very rare in literature. A 45-yr-old man with Behçet's disease manifesting focal epileptic seizure and multiple cerebral abscesses is reported in the case. He was diagnosed with cerebral abscess and was treated with antibiotics but no improvement occurred. Excisional biopsy was performed and the lesions were consistent with abscess. The clinical state of the patient gradually improved. The patient had no further complications. The etiology, and clinical and magnetic resonance...

---

Journal of Epilepsy and Clinical Neurophysiology — Mon, 30 Jan 2012 02:48:25 +0100

(Source: Journal of Epilepsy and Clinical Neurophysiology)

Electroencephalografic abnormalities as prognostic factor in acute coma in non-epileptic children

Journal of Epilepsy and Clinical Neurophysiology — Mon, 30 Jan 2012 02:48:25 +0100

Conclusion: In spite of the fact that our sample is relatively small, we infer that epileptogenic paroxysms in the EEGs of non-epileptic children in coma is relatively common, even not observing a consistent association of this finding with high risk of death. (Source: Journal of Epilepsy and Clinical Neurophysiology)

The usefulness of neuronavigation in functional hemispherectomy

Journal of Epilepsy and Clinical Neurophysiology — Mon, 30 Jan 2012 02:48:25 +0100

We report two cases of 5-year-old girls. The first one had a diagnosis of Rasmussens syndrome. The second one had a large porencephalic cyst secondary to perinatal cerebral ischemia. Despite trials of anticonvulsants, both patients deteriorated, and a functional hemispherectomy guided by neuronavigation was indicated and performed, with low morbidity and excellent seizure control. The neuronavigation proved to be a valuable guidance tool in performing the functional hemispherectomy, making the disconnections more accurate, and thus decreasing the surgical time and blood loss.Aplicabilidade da neuronavegação em hemisferectomia funcional As encefalopatias epilépticas catastróficas da infância compreendem condições graves que associam disfunção cerebral e crises epilépticas refrat...

Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. New paradigms?

Journal of Epilepsy and Clinical Neurophysiology — Mon, 30 Jan 2012 02:48:25 +0100

Conclusion: The ILAE Commission on Classification and Terminology has revised concepts, terminology, and approaches for classifying seizures and forms of epilepsy and the results of the discussion group were published in 2010 and the final report will be released in 2013. (Source: Journal of Epilepsy and Clinical Neurophysiology)

Epilepsy Emergencies: Diagnosis and Management

Neurologic Clinics — Mon, 30 Jan 2012 02:28:35 +0100

Seizures and status epilepticus are epilepsy emergencies with high morbidity and mortality. Early treatment is crucial, and the identification of an underlying etiology informs both continued treatment and prognosis. Many patients have underdiagnosed nonconvulsive seizures or nonconvulsive status epilepticus, particularly the comatose or critically ill. Timely EEG can be useful for diagnosis, management, optimizing treatment response, and determining prognosis in these patients. Refractory conditions can be quite complicated with limited evidence-based guidance, but treatment should not be restricted by nihilism even in the most prolonged cases, especially if there is not widespread irreversible brain injury. (Source: Neurologic Clinics)

Paroxysmal non‐epileptic motor events in childhood: a clinical and video‐EEG–polymyographic study

Developmental Medicine and Child Neurology — Sun, 29 Jan 2012 23:30:13 +0100

Aim The aim of this article was to describe the phenomenology and polymyographic features of paroxysmal non‐epileptic motor events (PNMEs) observed in a series of typically developing and children with neurological impairment.Method We conducted a retrospective evaluation of 63 individuals (29 females; 34 males) affected by PNMEs at the National Neurological Institute ‘C. Besta’ between 2006 and 2008. Individuals were included in the study if they had PNMEs documented by a video‐electroencephalography–polymyographic study and were aged between 1 month and 18 years (mean age at the time of video‐electroencephalography–polymyography: 5y 10mo).Results In 45 of the 63 participants (71%), PNMEs were associated with other neurological conditions (secondary) including e...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Older Medications for Epilepsy Obtain Better Control but Have More Adverse Effects

MedlinePlus Health News — Sat, 28 Jan 2012 12:42:57 +0100

Source: Agency for Healthcare Research and Quality Related MedlinePlus Page: Epilepsy (Source: MedlinePlus Health News)

Semantic memory is impaired in patients with unilateral anterior temporal lobe resection for temporal lobe epilepsy

Brain — Sat, 28 Jan 2012 05:00:00 +0100

In this study, therefore, we investigated the semantic performance of 20 patients with resection for chronic temporal lobe epilepsy with a full battery of semantic assessments, including more sensitive measures of semantic processing. The results provide a bridge between the current clinical observations about resection for temporal lobe epilepsy and the expectations from semantic dementia and other neuroscience findings. Specifically, we found that on simple semantic tasks, the patients’ accuracy fell in the normal range, with the exception that some patients with left resection for temporal lobe epilepsy had measurable anomia. Once the semantic assessments were made more challenging, by probing specific-level concepts, lower frequency/more abstract items or measuring reaction times...

Spreading convulsions, spreading depolarization and epileptogenesis in human cerebral cortex

Brain — Sat, 28 Jan 2012 05:00:00 +0100

Spreading depolarization of cells in cerebral grey matter is characterized by massive ion translocation, neuronal swelling and large changes in direct current-coupled voltage recording. The near-complete sustained depolarization above the inactivation threshold for action potential generating channels initiates spreading depression of brain activity. In contrast, epileptic seizures show modest ion translocation and sustained depolarization below the inactivation threshold for action potential generating channels. Such modest sustained depolarization allows synchronous, highly frequent neuronal firing; ictal epileptic field potentials being its electrocorticographic and epileptic seizure its clinical correlate. Nevertheless, Leão in 1944 and Van Harreveld and Stamm in 1953 described ...

Polymicrogyria: correlation of magnetic resonance imaging and clinical findings

Child's Nervous System — Fri, 27 Jan 2012 17:55:31 +0100

Conclusions Late presenting epilepsy may be a predictor of a unilateral polymicrogyria and is associated with relatively good prognosis. CMV infection and the presence of asphyxia are predictors of worse prognosis. Content Type Journal ArticleCategory Original PaperPages 1-5DOI 10.1007/s00381-012-1703-2Authors Ertugrul Mavili, Department of Radiology, Faculty of Medicine, Erciyes University, 38039 Melikgazi, Kayseri, TurkeyAbdulhakim Coskun, Department of Radiology, Faculty of Medicine, Erciyes University, 38039 Melikgazi, Kayseri, TurkeyHuseyin Per, Department of Pediatrics, Faculty of Medicine, Division of Pediatric Neurology, Erciyes University, Kayseri, TurkeyHalil Donmez, Department of Radiology, Faculty of Medicine, Erciyes University, 38039 Melikgazi, Kayseri,...

Keppra® Approved By FDA For Childhood Seizures

Health News from Medical News Today — Fri, 27 Jan 2012 17:00:00 +0100

In the U.S., Keppra® has been approved as adjunctive therapy for partial onset seizures in adults and children aged four years and older with epilepsy. However the UCB recently announced that the U.S. Food and Drug Administration (FDA) has now approved to lower the age restriction to include infants from the age of one month and older with epilepsy. Professor Dr. Iris Loew-Friedrich, Chief Medical Officer and Executive Vice President UCB â�¨declared: â�¨"As a leader in epilepsy UCB has a responsibility to develop effective medicines that address unmet medical needs... (Source: Health News from Medical News Today)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Risk of neurological diseases among survivors of electric shocks: A nationwide cohort study, Denmark, 1968–2008

Bioelectromagnetics — Fri, 27 Jan 2012 08:35:32 +0100

AbstractSeveral studies suggest a link between electric injuries and neurological diseases, where electric shocks may explain elevated risks for neuronal degeneration and, subsequently, neurological diseases. We conducted a retrospective cohort study on the risk of neurological diseases among people in Denmark who had survived an electric accident in 1968–2008. The cohort included 3,133 people and occurrences of neurological diseases were determined by linkage to the nationwide population‐based Danish National Register of Patients. The numbers of cases observed at first hospital contact in the cohort were compared with the respective rates of first hospital contacts for neurological diseases in the general population. We observed significantly increased risks for peripheral nerve disea...

Neurobiological Basis of Autism

Pediatric Clinics of North America — Fri, 27 Jan 2012 06:14:51 +0100

Autism (autism spectrum disorders) is a complex, strongly genetically influenced, behaviorally defined disorder of the immature brain associated with very uneven intellectual abilities. Among its most salient and potentially treatable neurologic features that this article focuses on are epilepsy, disorganized sleep patterns, and sensory and motor deficits. Its many causes and wide range of severity means that there is no symptom, no pathology, imaging, electroencephalography, or other biologic feature, and no biologic treatment that is universal or diagnostic of this developmental syndrome. (Source: Pediatric Clinics of North America)

Practice: Newer drugs for focal epilepsy in adults

NeLM - News — Fri, 27 Jan 2012 05:00:00 +0100

Source: BMJ Area: News This review in the BMJ focuses on new drugs for focal epilepsy in adults. The review starts with the case of a patient presenting to their GP and covers the following: . What are the newer antiepileptic drugs? . How well do the newer antiepileptic drugs work? - Add-on therapy - Monotherapy . How safe are the newer antiepileptic drugs? . What are the precautions? . How are the newer antiepileptic drugs taken and monitored? . How cost effective are the newer antiepileptic drugs? . How do the newer antiepileptic drugs compare with the establis...

Texture analysis of high resolution MRI allows discrimination between febrile and afebrile initial precipitating injury in mesial temporal sclerosis

Magnetic Resonance in Medicine — Fri, 27 Jan 2012 05:00:00 +0100

AbstractA computational pipeline combining texture analysis and pattern classification algorithms was developed for investigating associations between high‐resolution MRI features and histological data. This methodology was tested in the study of dentate gyrus images of sclerotic hippocampi resected from refractory epilepsy patients. Images were acquired using a simple surface coil in a 3.0T MRI scanner. All specimens were subsequently submitted to histological semiquantitative evaluation. The computational pipeline was applied for classifying pixels according to: a) dentate gyrus histological parameters and b) patients' febrile or afebrile initial precipitating insult history. The pipeline results for febrile and afebrile patients achieved 70% classification accuracy, with 78% sensitivi...

Vigabatrin for Childhood Partial-Onset Epilepsies

Pediatric Neurology — Fri, 27 Jan 2012 01:46:49 +0100

Abstract: To determine vigabatrin’s effectiveness and the prevalence of symptomatic visual impairment (i.e., impairment affecting the ability to perform everyday activities) associated with its therapy in pediatric epilepsy, we retrospectively reviewed medical records of 156 patients receiving vigabatrin at Cincinnati Children’s Medical Center from 1998-2010. In addition to demographics and vigabatrin dosing information, data included seizure type/frequency at presentation and subsequent follow-up. Of 156 patients, we excluded 35 because their medical records were insufficient to permit verification of the exact duration or timing of vigabatrin treatment. To evaluate efficacy (n = 121/135), we used a 5-point scale (0-4) to compare seizure frequency at several time points. To evaluate ...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Historic, Clinical, and Prognostic Features of Epileptic Encephalopathies Caused by CDKL5 Mutations

Pediatric Neurology — Fri, 27 Jan 2012 01:46:49 +0100

Abstract: Mutations within the X-linked cyclin-dependent kinase-like 5 (CDKL5) gene are important causes of early-onset epileptic encephalopathies. We sought to determine the historic, clinical, and prognostic features of epilepsy secondary to CDKL5 mutations. We performed retrospective chart reviews of children at our institution with epilepsy and CDKL5 mutations. Six children were identified. One manifested a deletion in exons 10-15 of the CDKL5 gene, another manifested a single base-pair duplication in exon 3, and the rest manifested base-pair exchanges. The mean age of seizure onset was 1.8 months (range, 1-3 months). Although the majority (4/6, 67%) presented with partial-onset seizures, all children developed infantile spasms. All children demonstrated developmental delay and visual ...

TUBA1A Mutation-Associated Lissencephaly: Case Report and Review of the Literature

Pediatric Neurology — Fri, 27 Jan 2012 01:46:49 +0100

We describe a 14-month-old girl with TUBA1A mutation-associated lissencephaly, and summarize the clinical and neuroradiologic findings of 19 cases in the literature. (Source: Pediatric Neurology)

Seizure risk increased before and after psychiatric hospitalization

MedWire News - Psychiatry — Fri, 27 Jan 2012 00:00:00 +0100

Vigabatrin versus carbamazepine monotherapy for epilepsy.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: There is currently insufficient data to address the risk-benefit balance of using VGB versus CBZ monotherapy for epilepsy. Considering the high prevalence of visual field defects, reported in an existing systematic review of observational studies (Maguire 2010), the prescribing of VGB monotherapy for epilepsy should be used with caution and not considered as a first-line choice. If necessary, a frequent assessment of visual field is needed. Future research should focus on investigating the reasons for visual field defects and exploring the potential prevention strategies. Moreover, future monotherapy studies of epilepsy should report results according to the recommendation of International League Against Epilepsy (ILAE) Commission, and methodological quality should be improve...

New advice on anti-epileptic drugs

NHS Networks — Thu, 26 Jan 2012 05:00:00 +0100

Epilepsy affects up to an estimated 415,000 people in England, and two-thirds of people with active epilepsy have their condition satisfactorily controlled by AEDs. NICE first published guidance on epilepsy in 2004 that included recommendations on the use of AEDs, as well as advice on the diagnosis, treatment and further management of the condition. As recent years have seen a rise in the number of AEDs being prescribed, NICE has now updated this clinical guideline to provide information on newer AEDs. The update describes how and when newer AEDs should be considered alongside older medicines, and can help GPs ensure they are prescribing treatments that are effective both clinically and cost effective. (Source: NHS Networks)

MedWorm Sponsor Message: Find the best January Sales in the UK.

NICE issues guidelines on diagnosis and management of the epilepsies in adults and children in primary and secondary care

NeLM - Guidelines — Thu, 26 Jan 2012 05:00:00 +0100

Source: NICE Area: Evidence > Guidelines This clinical guideline offers evidence-based advice on the care and treatment of children, young people and adults with epilepsy. It updates and replaces NICE clinical guideline 20, published in 2004 and NICE technology appraisal 76 (2004) and 79 (2004). New recommendations have been added for the pharmacological treatment of people with epilepsy, including the use of ketogenic diet. (Source: NeLM - Guidelines)

Comorbidities Likely in Children With EpilepsyComorbidities Likely in Children With Epilepsy

Medscape Today Headlines — Wed, 25 Jan 2012 21:29:14 +0100

High levels of developmental and mental health comorbidities signal the need for a proactive approach in treating the estimated 1% of children with seizures. Medscape Medical News (Source: Medscape Today Headlines)

The contribution of posterior circulation to memory function during the intracarotid amobarbital procedure

Journal of Neurology — Wed, 25 Jan 2012 18:13:21 +0100

Abstract The purpose of this study was to evaluate the contribution of posterior circulation to memory function by comparing memory scores between patients with and without a foetal-type posterior cerebral artery (FTP) during the intracarotid amobarbital procedure (IAP) in epilepsy patients. Patients undergoing bilateral IAP between January 2004 and January 2010 were retrospectively included. Pre-test angiograms were assessed for the presence of a FTP. Memory function scores (% correct) after right and left injections were obtained. Functional significance of FTP was affirmed by relative occipital versus parietal EEG slow-wave increase during IAP. Memory and EEG scores were compared between patients with and without FTP (Mann–Whitney U test). A total of 106 patients ...

Automated Algorithm for Generalized Tonic–Clonic Epileptic Seizure Onset Detection Based on sEMG Zero-Crossing Rate

IEEE Transactions on Biomedical Engineering — Wed, 25 Jan 2012 14:46:10 +0100

Patients are not able to call for help during a generalized tonic–clonic epileptic seizure. Our objective was to develop a robust generic algorithm for automatic detection of tonic–clonic seizures, based on surface electromyography (sEMG) signals suitable for a portable device. Twenty-two seizures were analyzed from 11 consecutive patients. Our method is based on a high-pass filtering with a cutoff at 150 Hz, and monitoring a count of zero crossings with a hysteresis of $pm 50,mu hbox{V}$ . Based on data from one sEMG electrode (on the deltoid muscle), we achieved a sensitivity of 100% with a mean detection latency of 13.7 s, while the rate of false detection was limited to 1 false alarm per 24 h. The overall performance of the presented generic algorith...

Cross Validation for Selection of Cortical Interaction Models From Scalp EEG or MEG

IEEE Transactions on Biomedical Engineering — Wed, 25 Jan 2012 14:46:09 +0100

A cross-validation (CV) method based on state-space framework is introduced for comparing the fidelity of different cortical interaction models to the measured scalp electroencephalogram (EEG) or magnetoencephalography (MEG) data being modeled. A state equation models the cortical interaction dynamics and an observation equation represents the scalp measurement of cortical activity and noise. The measured data are partitioned into training and test sets. The training set is used to estimate model parameters and the model quality is evaluated by computing test data innovations for the estimated model. Two CV metrics normalized mean square error and log-likelihood are estimated by averaging over different training/test partitions of the data. The effectiveness of this method of model selecti...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

[Epileptic asystole - a case report.]

Kardiologia Polska — Wed, 25 Jan 2012 06:54:02 +0100

We present a case of a 45 year-old woman with epilepsy diagnosed 24 years earlier. Epilepsy was confirmed by EEG and many seizures episodes were treated with different combination of anticonvulsive drugs. A 24-h Holter ECG monitoring revealed an episode of asystole lasting 82 s. The pacemaker was implanted and antiepileptic therapy with valproic acid chrono (1800 mg/d.) was continued. We review in this article present data on arrhythmic epilepsy. Kardiol Pol 2012; 70, 1: 64-65. PMID: 22267431 [PubMed - as supplied by publisher] (Source: Kardiologia Polska)

The Use of All Three Test of Memory Malingering Trials in Establishing the Level of Effort.

Archives of Clinical Neuropsychology — Wed, 25 Jan 2012 05:00:00 +0100

This study examined all three trials of the Test of Memory Malingering (TOMM) in a large sample (n = 213) of inpatients on an epilepsy monitoring unit with the goal of establishing cut scores for early termination. TOMM Trial 1 demonstrated impressive diagnostic accuracy for determining both adequate and suboptimal levels of effort; various cut scores and classification statistics are presented. The optional Retention trial from the TOMM also increased the hit rate 16% in the detection of poor effort. Clinical implications, limitations, and directions for further research are discussed. PMID: 22277125 [PubMed - as supplied by publisher] (Source: Archives of Clinical Neuropsychology)

Diagnostic yield and predictive value of provoked ictal SPECT in drug-resistant epilepsies

Journal of Neurology — Tue, 24 Jan 2012 18:09:45 +0100

Abstract Brain single photon emission computed tomography (SPECT) can be a useful tool to identify the epileptogenic zone in selected patients. However, ictal SPECT during spontaneous seizures is difficult to obtain and can be expensive, due to extra hospitalization time and personnel resource utilization. The efficacy of ictal SPECT depends on the ability to inject as early as possible after the beginning of the ictal discharge and/or the occurrence of the first symptom and is challenged by the short duration and rapid propagation of seizures, especially extratemporal seizures. We studied 52 patients with drug-resistant epilepsy who underwent ictal SPECT during provoked seizures in order to demonstrate the efficacy of this technique to define the epileptogenic zone and it...

Classical MERRF phenotype associated with mitochondrial tRNALeu (m.3243A>G) mutation

European Journal of Pediatrics — Tue, 24 Jan 2012 07:54:08 +0100

This report highlights the broad phenotypic variability of mitochondrial encephalopathies with juvenile onset. It shows that m.3243A>G mutations can cause classical MERRF and emphasises the significance of comprehensive genetic studies if mitochondrial disease is suspected clinically. Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s00431-011-1662-8Authors Florian Brackmann, Department of Pediatrics, Friedrich-Alexander-University of Erlangen–Nuremberg, Loschgestrasse 15, 91054 Erlangen, GermanyAngela Abicht, Medical Genetic Center, Munich, GermanyUwe Ahting, Department Klinische Chemie, Städtisches Klinikum, Munich, GermanyRolf Schröder, Friedrich-Alexander-University of Erlangen-Nuremberg, Institute of Neuropathology, Erlangen, Bavaria, GermanyRegina...

State-dependent precursors of seizures in correlation-based functional networks of electrocorticograms of patients with temporal lobe epilepsy

Neurological Sciences — Tue, 24 Jan 2012 07:34:36 +0100

Abstract Accurate prediction of epileptic seizures will open novel therapeutic possibilities for patients with intractable epilepsy. We attempted to identify precursors of seizures in the functional networks of electrocorticograms by applying graph theory. Long-term electrocorticograms for periods of 39–76 h from three patients with temporal lobe epilepsy were investigated using pair-wise cross-correlations. Time-varying network properties suggested that there were several distinct brain states. Although functional networks during seizures could be characterized as having a regular topography, no consistent characteristics of functional networks were found immediately prior to seizure onsets. However, it was found that seizures under an identical state were followed...

MedWorm Sponsor Message: Find the best January Sales in the UK.

The adverse event profile of pregabalin across different disorders: a meta-analysis

European Journal of Clinical Pharmacology — Tue, 24 Jan 2012 07:20:02 +0100

Conclusions Although drug-resistant partial epilepsy is associated with a higher probability of developing vestibulo-cerebellar AEs, the risk for PGB toxicity does not differ across distinct disorders. Content Type Journal ArticleCategory Clinical TrialPages 1-10DOI 10.1007/s00228-012-1213-xAuthors Gaetano Zaccara, U.O. Neurologia, Azienda Sanitaria di Firenze, Firenze, ItalyPiero Perucca, Montreal Neurological Institute, McGill University, Montreal, Quebec, CanadaPier Franco Gangemi, Anffas Rehabilitation Institute, Firenze, Italy Journal European Journal of Clinical PharmacologyOnline ISSN 1432-1041Print ISSN 0031-6970 (Source: European Journal of Clinical Pharmacology)

Imidazole as an anti-epileptic: an overview

Medicinal Chemistry Research — Tue, 24 Jan 2012 06:47:50 +0100

Abstract Imidazole is incorporated into many important biological molecules. The major revolution in the field of imidazole derivatives with antiepileptic properties came with the synthesis of Denzimol and Nafimidone, which leads in its effectiveness among other molecules. The pharmacophore and substitution necessary to elevate the pharmacological effect of these derivatives in curing epilepsy are presented in this review, which can serve the medicinal chemist working on epileptic research to focus on this untouched class of molecules and enlarge its category and synthesize more active and potent anticonvulsant agents. Content Type Journal ArticleCategory Review ArticlePages 1-11DOI 10.1007/s00044-012-9972-6Authors Rahul Mishra, Department of Pharmaceutical Science, B...

Genetic Polymorphism of NAT2 Metabolizing Enzymes on Phenytoin Pharmacokinetics in Indian Epileptic Patients Developing Toxicity.

CNS Neuroscience and Therapeutics — Tue, 24 Jan 2012 05:00:00 +0100

Conclusion: Our findings suggest that the NAT2*5A genetic polymorphisms plays a significant role in the steady-state concentrations of phenytoin and thereby have impact on toxicity in epileptic patients. PMID: 22268821 [PubMed - as supplied by publisher] (Source: CNS Neuroscience and Therapeutics)

The enigma of long-term forgetting

Seizure: European Journal of Epilepsy — Tue, 24 Jan 2012 05:00:00 +0100

Memory symptoms are common among people with epilepsy (pwe). Their complaints are often corroborated by impairments on traditional tests of memory which assess learning and retention over delays of up to 30min. Yet a substantial minority of patients report memory problems which are not identified on standard testing. This discrepancy has sometimes been ascribed to mood disorders. There is, however, an alternative, or complementary, explanation: that established methods of memory testing fail to detect some genuine memory problems. Standard tests, for example, seldom assess autobiographical memory or retention of new information over delays greater than 30min. A growing literature reports patients with epilepsy, usually arising from the temporal lobes (TLE), who show normal or near normal r...

Development and Validation of a Fluorescence-based HTS Assay for the Identification of P/Q-Type Calcium Channel Blockers.

Combinatorial Chemistry and High Throughput Screening — Tue, 24 Jan 2012 05:00:00 +0100

Authors: Mezler M, Hermann D, Swensen AM, Draguhn A, Terstappen GC, Gross G, Schoemaker H, Freiberg G, Pratt S, Gopalakrishnan SM, Nimmrich V Abstract Dysfunction of P/Q-type calcium channels is thought to underlie a variety of neurological diseases. There is evidence that migraine, Alzheimer´s disease, and epilepsy involve a gain-of-function of the channel, leading to abnormal presynaptic vesicle release. P/Q-channel blockers may normalize current flow and consequently lead to an alleviation of disease symptoms. Although the medical need is high, there are no such compounds on the market. Here we describe a high-throughput screen for P/Q-type calcium channel blockers and the confirmation of hits by automated electrophysiology. We generated a HEK293 cell line stably expressing the...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

UCSF shares $25-million grant to find epilepsy genes

EurekAlert! - Medicine and Health — Mon, 23 Jan 2012 05:00:00 +0100

(University of California - San Francisco) To probe the genetic secrets of one of the most common neurological diseases, more than 4,000 people with various forms of epilepsy will have their DNA decoded over the next five years in a study led by researchers at the University of California, San Francisco and several collaborating institutions. (Source: EurekAlert! - Medicine and Health)

Ketone Bodies in Epilepsy

Journal of Neurochemistry — Mon, 23 Jan 2012 05:00:00 +0100

AbstractSeizures that are resistant to standard medications remain a major clinical problem. One underutilized option for patients with medication‐resistant seizures is the high‐fat, low‐carbohydrate ketogenic diet. The diet received its name based on the observation that patients consuming this diet produce ketone bodies (e.g., acetoacetate, β‐hydroxybutyrate, and acetone). Although the exact mechanisms of the diet are unknown, ketone bodies have been hypothesized to contribute to the anticonvulsant and antiepileptic effects. In this review, anticonvulsant properties of ketone bodies and the ketogenic diet are discussed (including GABAergic and glutamatergic effects). Because of the importance of ketone body metabolism in the early stages of life, the effects of ketone bodies on ...

Disparities in NIH funding for epilepsy research

Neurology — Mon, 23 Jan 2012 05:00:00 +0100

(Source: Neurology)

UCSF Shares $25-Million Grant To Find Epilepsy Genes

UCSF Medical Center — Mon, 23 Jan 2012 05:00:00 +0100

To probe the genetic secrets of one of the most common neurological diseases, more than 4,000 people with various forms of epilepsy will have their DNA decoded over the next five years in a study led by researchers at the University of California, San Francisco (UCSF) and several collaborating institutions. (Source: UCSF Medical Center)

Clinical decision rules for the assessment of mild head injury, used in combination with clinical judgment, can inform the use of head imaging

Evidence-Based Medicine — Mon, 23 Jan 2012 05:00:00 +0100

Context CT is currently the primary modality for investigating possible intracranial injury. The benefit of CT scanning for head injury in certain circumstances was recognised more than 30 years ago,1 but only recently have restrictive protocols based on specialist authorisation given way to a liberal approach with unrestricted access to CT scans in most high income countries. Recently, the long-term effects of radiation have been re-emphasised along with the cost of indiscriminate CT scanning, highlighting the need to determine the optimal use of CT scans for minor head injury. Methods In this systematic review, Pandor et al aimed to determine the most appropriate diagnostic imaging strategy for adults and children with minor Glasgow Coma Scale (GCS) 13–15 head injury through a syst...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Self-injury in people with intellectual disability and epilepsy: A matched controlled study. - Serafino B, Fabio S, Bernadette PM, Maurizio E, Mike K, Santo DN.

SafetyLit: All (Unduplicated) — Sat, 21 Jan 2012 12:05:52 +0100

We aimed to identify the presence of self-injurious behavior in a sample of 158 people with intellectual disability and epilepsy as compared with a control sample consisting of 195 people with intellectual disability without epilepsy. The Italian Scale for... (Source: SafetyLit: All (Unduplicated))

Genetics of Epilepsy

Seminars in Neurology — Sat, 21 Jan 2012 05:00:00 +0100

Semin Neurol 2011; 31: 506-518DOI: 10.1055/s-0031-1299789ABSTRACTEpilepsy is a common and very heterogeneous neurologic disorder. Genetic factors are likely to play a role in most cases, either because the underlying cause of epilepsy is primarily genetic or because genes modulate susceptibility to an epileptogenic insult. Primarily genetic epilepsies include conditions in which altered brain development or neurodegeneration are at the basis of seizures, but also conditions in which the brain is grossly normal, and the main, if not only, clinical feature is epilepsy. These are called idiopathic epilepsies, though this definition may change in the future. A few idiopathic epilepsies are monogenic disorders due to mutations in a variety of genes affecting neuronal excitability, synaptic tran...

Aquaporins in clinical medicine.

Annual Review of Medicine — Fri, 20 Jan 2012 09:00:36 +0100

Authors: Verkman AS Abstract The aquaporins are a family of membrane water channels, some of which also transport glycerol. They are involved in a wide range of physiological functions (including water/salt homeostasis, exocrine fluid secretion, and epidermal hydration) and human diseases (including glaucoma, cancer, epilepsy, and obesity). At the cellular level, aquaporin-mediated osmotic water transport across cell plasma membranes facilitates transepithelial fluid transport, cell migration, and neuroexcitation; aquaporin-mediated glycerol transport regulates cell proliferation, adipocyte metabolism, and epidermal water retention. Genetic diseases caused by loss-of-function mutations in aquaporins include nephrogenic diabetes insipidus and congenital cataracts. The neuroinflammat...

Distribution of 5‐HT1E receptors in the mammalian brain and cerebral vasculature: an immunohistochemical and pharmacological study

British Journal of Pharmacology — Fri, 20 Jan 2012 05:00:00 +0100

Conclusions and Implications. These observations should help predict the clinical effects of 5‐HT1E‐selective drugs. For example, we have confirmed a functional link between the stimulation of 5‐HT1E receptors and the inhibition of adenylate cyclase activity in the dentate gyrus; this suggests 5‐HT1E receptors may mediate serotonin's regulation of hippocampal activity, making it a possible drug target for the treatment of neuropsychiatric disorders characterized by memory deficits (e.g. Alzheimer's disease) or as a target for the treatment of temporal lobe epilepsy. (Source: British Journal of Pharmacology)

Blanket ban on lithium for women wanting a baby unwarranted

OnMedica Latest News — Fri, 20 Jan 2012 05:00:00 +0100

Evidence on link to congenital abnormalities unclearRelated items from OnMedicaMortality higher if using paroxetine and tamoxifenSSRIs raise risk of rare neonatal hypertensionDrug reactions common in hospitalsNew warning on epilepsy drugs in pregnancyAsthma boosts risk of perinatal complications and premature birth (Source: OnMedica Latest News)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

PCDH19‐related Infantile Epileptic Encephalopathy: An Unusual X‐linked Inheritance Disorder

Human Mutation — Fri, 20 Jan 2012 05:00:00 +0100

AbstractPCDH19 encodes protocadherin 19 on chromosome Xq22.3. This 1148 amino‐acid protein, highly expressed during brain development, could play significant roles in neuronal migration or establishment of synaptic connections. PCDH19 is composed of 6 exons, with a large first exon encoding the entire extracellular domain of the protein. Heterozygous PCDH19 mutations were initially identified in epilepsy and mental retardation limited to females, a familial disorder with a singular mode of inheritance since only heterozygous females are affected whereas hemizygous males are asymptomatic. Yet, mosaic males can also be affected, supporting cellular interference as the pathogenic mechanism. Recently, mutations in PCDH19, mostly occurring de novo, were shown to be a frequent cause of sporadi...

Neurological Abnormalities in Opiate Addicts with and without Substitution Therapy.

The American Journal of Drug and Alcohol Abuse — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion: All opiate addicts under substitution therapy present with neurological abnormalities. The high prevalence of neurological abnormalities in opiate addicts implies regular referral of these patients to the neurologist to improve their outcome. PMID: 22263960 [PubMed - as supplied by publisher] (Source: The American Journal of Drug and Alcohol Abuse)

First long-term experience with the orphan drug rufinamide in children with myoclonic-astatic epilepsy (Doose syndrome).

European Journal of Paediatric Neurology — Fri, 20 Jan 2012 05:00:00 +0100

CONCLUSION: RUF seems to be a promising therapeutic option in children with MAE. Further studies are warranted to confirm these first observations. PMID: 22266062 [PubMed - as supplied by publisher] (Source: European Journal of Paediatric Neurology)

The paramedian supracerebellar-transtentorial approach to the entire length of the mediobasal temporal region: an anatomical and clinical study.

Journal of Neurosurgery — Fri, 20 Jan 2012 05:00:00 +0100

Conclusions The PST approach provides the surgeon precise anatomical orientation when exposing the entire length of the MTR, as well as the fusiform gyrus, for removing any lesion. This is a novel technique especially for removing tumors involving the entire MTR in a single session without damaging neighboring neural or vascular structures. This approach can also be a viable alternative for selective removal of the parahippocampal gyrus, hippocampus, and amygdala in patients with MTE due to hippocampal sclerosis. PMID: 22264179 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

Ex-Kansas City charity leader pleads guilty to fraud scheme

bizjournals.com Health Care:Physician Practices headlines — Thu, 19 Jan 2012 22:33:13 +0100

A former Kansas City resident pleaded guilty Thursday to embezzling at least $100,000 while working as an executive for two area nonprofit organizations. Sean Patrick Taylor, also known as J.R. Wayne Gourley, 52, pleaded guilty in U.S. District Court in Kansas City to charges in an Aug. 10 indictment, according to a release from the office of Beth Phillips, U.S. Attorney for the Western District of Missouri. Taylor admitted that he embezzled money from the Epilepsy Foundation of Kansas and Western Missouri and Westport Cooperative Services between April 2007 and May 2010... (Source: bizjournals.com Health Care:Physician Practices headlines)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Acquired encephalopathy associated with carnitine deficiency after cefditoren pivoxil administration

Neurological Sciences — Thu, 19 Jan 2012 06:56:21 +0100

We describe a 47-year-old woman who presented with palinopsia and subacute altered mental change after cefditoren pivoxil administration. The patient showed characteristic clinical manifestations of hypocarnitinemia, which affected her state of consciousness and she had radiologic findings that revealed metabolic encephalopathy with cytotoxic edema in the right occipital area and intracranial hemorrhages in right occipital and left frontal areas. Follow-up imaging after oral carnitine supplementation demonstrated complete resolution of the bilateral frontal subcortical T2 high-intensity lesions. Carnitine deficiency due to cefditoren pivoxil treatment may present as metabolic encephalopathy in adults. This possibility should be considered with the differential diagnosis of encephalop...

Patient satisfaction and outcome using emergency care practitioners in New Zealand

Emergency Medicine Australasia — Thu, 19 Jan 2012 05:00:00 +0100

Conclusion: The avoidance of unnecessary transfers to hospital is beneficial to patients, the ambulance service and the ED. This study demonstrates that patients are very satisfied with their assessment and treatment by ECPs, endorsing the proposal that the scheme should be extended across the Wellington Region, and perhaps New Zealand. (Source: Emergency Medicine Australasia)

Lack of association between ABCC2 gene variants and treatment response in epilepsy

Future Medicine: Pharmacogenomics — Wed, 18 Jan 2012 13:45:40 +0100

Pharmacogenomics , January 2012, Vol. 13, No. 2, Pages 185-190. (Source: Future Medicine: Pharmacogenomics)

Citroen advert banned from TV after triggering epileptic seizures in viewers

the Mail online | Health — Wed, 18 Jan 2012 10:34:35 +0100

The adverts for the Citroen DS4 which appeared on Sky, Watch, ITV, Quest and UK Gold, showed rapidly-changing scenes and the word 'Yes' flashing across the screen in various forms. (Source: the Mail online | Health)

A Step Closer To Unlocking A Mystery That Causes Epileptic Seizures In Babies

Health News from Medical News Today — Wed, 18 Jan 2012 10:00:00 +0100

Benign familial infantile epilepsy (BFIE) has been recognised for some time as infantile seizures, without fever, that run in families but the cause has so far eluded researchers. However clinical researchers at the University of Melbourne and Florey Neurosciences Institute and molecular geneticists at the University of South Australia have discovered a gene. BFIE is a disorder that occurs in previously healthy infants who are developing normally. Seizures commence when a baby is about six months old and stop by the age of two years... (Source: Health News from Medical News Today)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Distinct DNA binding and transcriptional repression characteristics related to different ARX mutations

Neurogenetics — Wed, 18 Jan 2012 06:59:18 +0100

Abstract Mutations in the Aristaless-related homeobox gene (ARX) are associated with a wide variety of neurologic disorders including lissencephaly, hydrocephaly, West syndrome, Partington syndrome, and X-linked intellectual disability with or without epilepsy. A genotype–phenotype correlation exists for ARX mutations; however, the molecular basis for this association has not been investigated. To begin understanding the molecular basis for ARX mutations, we tested the DNA binding sequence preference and transcriptional repression activity for Arx, deletion mutants and mutants associated with various neurologic disorders. We found DNA binding preferences of Arx are influenced by the amino acid sequences adjacent to the homeodomain. Mutations in the homeodomain show a loss ...

Identification of a novel in-frame de novo mutation in SPTAN1 in intellectual disability and pontocerebellar atrophy

European Journal of Human Genetics — Wed, 18 Jan 2012 05:00:00 +0100

Authors: Fadi F Hamdan, Hirotomo Saitsu, Kiyomi Nishiyama, Julie Gauthier, Sylvia Dobrzeniecka, Dan Spiegelman, Jean-Claude Lacaille, Jean-Claude Décarie, Naomichi Matsumoto, Guy A Rouleau & Jacques L Michaud (Source: European Journal of Human Genetics)

Mortality and morbidity in the city of Bern, Switzerland, 1805-1815 with special emphasis on infant, child and maternal deaths.

Homo — Wed, 18 Jan 2012 05:00:00 +0100

This article contributes to the research on demographics and public health of urban populations of preindustrial Europe. The key source is a burial register that contains information on the deceased, such as age and sex, residence and cause of death. This register is one of the earliest compilations of data sets of individuals with this high degree of completeness and consistency. Critical assessment of the register's origin, formation and upkeep promises high validity and reliability. Between 1805 and 1815, 4390 deceased inhabitants were registered. Information concerning these individuals provides the basis for this study. Life tables of Bern's population were created using different models. The causes of death were classified and their frequency calculated. Furthermore, the susceptibili...

Because scientists are unable to explain the unexplained, screening for cardiovascular abnormalities is a good method to protect against sudden unexpected death in patients with epilepsy

Clinics — Wed, 18 Jan 2012 00:35:44 +0100

(Source: Clinics)

ASA says no to Citroen 'yes' ad

BBC News | Health | UK Edition — Wed, 18 Jan 2012 00:00:26 +0100

A television advertisement for Citroen is banned after complaints claiming it causes epilepsy symptoms or seizures. (Source: BBC News | Health | UK Edition)

MedWorm Sponsor Message: Find the best January Sales in the UK.

The EMA is recommending the authorisation of lacosamide [Vimpat] syrup for patients with epilepsy

Reactions — Tue, 17 Jan 2012 19:08:18 +0100

(Source: Reactions)

Epilepsy associated with glutamic acid decarboxylase antibody (GADA)

European Journal of Neurology — Tue, 17 Jan 2012 05:00:00 +0100

(Source: European Journal of Neurology)

Magnetic resonance imaging abnormalities in children with epilepsy

European Journal of Neurology — Tue, 17 Jan 2012 05:00:00 +0100

Conclusions: The use of MRI and a reliable standardized scoring system at diagnosis of epilepsy in children identified a high rate of significant abnormalities findings. This may have important implications for practice guidelines in this population. (Source: European Journal of Neurology)

More on epilepsy before I sign off!

Annals of Indian Academy of Neurology — Tue, 17 Jan 2012 05:00:00 +0100

Sanjeev V ThomasAnnals of Indian Academy of Neurology 2011 14(4):231-231 (Source: Annals of Indian Academy of Neurology)

Repetitive transcranial magnetic stimulation in psychiatry

Annals of Indian Academy of Neurology — Tue, 17 Jan 2012 05:00:00 +0100

Biswa Ranjan Mishra, Sukanto Sarkar, Samir Kumar Praharaj, Varun S Mehta, Shreyansh Diwedi, S Haque NizamieAnnals of Indian Academy of Neurology 2011 14(4):245-251Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive and relatively painless tool that has been used to study various cognitive functions as well as to understand the brain-behavior relationship in normal individuals as well as in those with various neuropsychiatric disorders. It has also been used as a therapeutic tool in various neuropsychiatric disorders because of its ability to specifically modulate distinct brain areas. Studies have shown that repeated stimulation at low frequency produces long-lasting inhibition, which is called as long-term depression, whereas repeated high-frequency stimulation can produ...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Correlates of parental stress and psychopathology in pediatric epilepsy

Annals of Indian Academy of Neurology — Tue, 17 Jan 2012 05:00:00 +0100

Conclusion: The results of our study indicated that pediatric patients with epilepsy, specifically with intractable cases, are correlated with high levels of parental stress. (Source: Annals of Indian Academy of Neurology)

Quality of life in children with epilepsy

Annals of Indian Academy of Neurology — Tue, 17 Jan 2012 05:00:00 +0100

Conclusion: CWE have a relatively compromised QOL and comprehensive care needs to go beyond the attempt of controlling seizures. (Source: Annals of Indian Academy of Neurology)

Risk factors of childhood epilepsy in Kerala

Annals of Indian Academy of Neurology — Tue, 17 Jan 2012 05:00:00 +0100

Conclusion: Modifiable factors such as newborn distress and significant head trauma are significant risk factors for childhood epilepsy. Newborn distress is a risk factor for early-onset (<1 year age) epilepsy. (Source: Annals of Indian Academy of Neurology)

Trends in Resource Utilization by Children with Neurological Impairment in the United States Inpatient Health Care System: A Repeat Cross-Sectional Study

PLoS Medicine — Tue, 17 Jan 2012 05:00:00 +0100

by Jay G. Berry, Annapurna Poduri, Joshua L. Bonkowsky, Jing Zhou, Dionne A. Graham, Chelsea Welch, Heather Putney, Rajendu Srivastava Background Care advances in the United States (US) have led to improved survival of children with neurological impairment (NI). Children with NI may account for an increasing proportion of hospital resources. However, this assumption has not been tested at a national level. Methods and Findings We conducted a study of 25,747,016 US hospitalizations of children recorded in the Kids' Inpatient Database (years 1997, 2000, 2003, and 2006). Children with NI were identified with International Classification of Diseases, 9th Revision, Clinical Modification diagnoses resulting in functional and/or intellectual impairment. We assessed trends in inpatient resource ut...

Clinical outcomes, quality of life, and costs associated with implantation of vagus nerve stimulation therapy in pediatric patients with drug-resistant epilepsy.

European Journal of Paediatric Neurology — Tue, 17 Jan 2012 05:00:00 +0100

CONCLUSIONS: VNS in pediatric patients is associated with decreased resource use and epilepsy-related events, cost savings, and QALY gain. PMID: 22261080 [PubMed - as supplied by publisher] (Source: European Journal of Paediatric Neurology)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Ketogenic diet in early myoclonic encephalopathy due to non ketotic hyperglycinemia.

European Journal of Paediatric Neurology — Tue, 17 Jan 2012 05:00:00 +0100

We report three cases affected by neonatal non ketotic hyperglycinemia and early myoclonic encephalopathy treated with ketogenic diet. In our patients ketogenic diet, in association with standard pharmacological therapy, determined dramatic reduction of seizures and improved quality of life. PMID: 22261077 [PubMed - as supplied by publisher] (Source: European Journal of Paediatric Neurology)

'Neurology disease time bomb' facing the NHS says Neurological Alliance

Multiple Sclerosis Trust — Tue, 17 Jan 2012 00:00:00 +0100

The Neurological Alliance is an umbrella organisation representing 70 local and national charities who support people living with a neurological condition and includes the MS Trust, Parkinson's UK, Epilepsy Action and the Motor Neurone Disease Association. The comments follow publication of the report Services for people with neurological conditions by the National Audit Office last month. (Source: Multiple Sclerosis Trust)

Idiopathic Epilepsy

About.com Eating Disorders — Mon, 16 Jan 2012 05:00:00 +0100

Idiopathic epilepsy is a form of epilepsy where the cause of the seizures is unknown. (Source: About.com Eating Disorders)

New gene discovery unlocks mystery to epilepsy in infants

EurekAlert! - Medicine and Health — Mon, 16 Jan 2012 05:00:00 +0100

(University of Melbourne) A team of Australian researchers has come a step closer to unlocking a mystery that causes epileptic seizures in babies.Benign familial infantile epilepsy has been recognized for some time as infantile seizures, without fever, that run in families but the cause has so far eluded researchers. However, clinical researchers at the University of Melbourne and Florey Neurosciences Institute and molecular geneticists at the University of South Australia have discovered a gene. (Source: EurekAlert! - Medicine and Health)

Shared loci for migraine and epilepsy on chromosomes 14q12-q23 and 12q24.2-q24.3

Neurology — Mon, 16 Jan 2012 05:00:00 +0100

Conclusions: Our data suggest the occurrence of common susceptibility loci for epilepsy and migraine on chromosomes 14q12-q23 and 12q24.2-q24.3, implicating a shared genetic etiology for these 2 diseases. (Source: Neurology)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

A new measure of cortical inhibition by mechanomyography and paired-pulse transcranial magnetic stimulation in unanesthetized rats

Journal of Neurophysiology — Mon, 16 Jan 2012 05:00:00 +0100

Paired-pulse transcranial magnetic stimulation (ppTMS) is a safe and noninvasive tool for measuring cortical inhibition in humans, particularly in patients with disorders of cortical inhibition such as epilepsy. However, ppTMS protocols in rodent disease models, where mechanistic insight into the ppTMS physiology and into disease processes may be obtained, have been limited due to the requirement for anesthesia and needle electromyography. To eliminate the confounding factor of anesthesia and to approximate human ppTMS protocols in awake rats, we adapted the mechanomyogram (MMG) method to investigate the ppTMS inhibitory phenomenon in awake rats and then applied differential pharmacology to test the hypothesis that long-interval cortical inhibition is mediated by the GABAA receptor. Bilate...

Late mortality after severe traumatic brain injury in New South Wales: a multicentre study.

Med J Aust — Mon, 16 Jan 2012 05:00:00 +0100

CONCLUSIONS: People who survive to discharge from inpatient rehabilitation following a severe TBI were found to have a sustained increase in risk of death for eight years post discharge. Various demographic and injury-related variables selectively increase mortality risk and may be modifiable in order to reduce the observed increase in mortality. PMID: 22256933 [PubMed - in process] (Source: Med J Aust)

Violent crime, epilepsy, and traumatic brain injury. - Volavka J.

SafetyLit: All (Unduplicated) — Sat, 14 Jan 2012 23:37:57 +0100

Jan Volavka discusses new research by Seena Fazel and colleagues that reports increased risk for violent crime among people with traumatic brain injury and epilepsy. Language: Eng... (Source: SafetyLit: All (Unduplicated))

Evidence-based review on epilepsy and driving. - Classen S, Crizzle AM, Winter SM, Silver W, Eisenchenk S.

SafetyLit: All (Unduplicated) — Sat, 14 Jan 2012 23:37:57 +0100

OBJECTIVE: The aim of this study was to synopsize the evidence on predictors of crashes and driving status in people with epilepsy (PWE). METHODS: Evidence-based review of the published English literature was the method used. We searched various databases ... (Source: SafetyLit: All (Unduplicated))

Do recurrent seizure-related head injuries affect seizures in people with epilepsy? - Friedman DE, Chiang S, Tobias RS.

SafetyLit: All (Unduplicated) — Sat, 14 Jan 2012 23:37:57 +0100

Seizure-related head injuries (SRHIs) are among the most commonly encountered injuries in people with epilepsy (PWE). Whether head injury has an effect on preexisting epilepsy is not known. The purpose of this study was to systematically assess for any pos... (Source: SafetyLit: All (Unduplicated))

MedWorm Sponsor Message: Find the best January Sales in the UK.

What does epilepsy tell us about the neural correlates of consciousness? - Mann JP, Cavanna AE.

SafetyLit: All (Unduplicated) — Sat, 14 Jan 2012 23:37:57 +0100

Epilepsy and consciousness are intimately related. Epileptic seizures can cause impairment of consciousness, and the study of how this occurs has informed us about the neural mechanisms that underlie normal consciousness. Moreover, loss of consciousness du... (Source: SafetyLit: All (Unduplicated))

50 Years Ago in The Journal of Pediatrics: A Correlation of Clinical, Electroencephalographic, and Roentgenographic Findings in Children with Epilepsy

The Journal of Pediatrics — Sat, 14 Jan 2012 17:25:09 +0100

Lundervold A, Jabbour JT. J Pediatr 1962;60:220-3 When Lundervold and Jabbour studied childhood epilepsy, there were only a handful of anticonvulsants, some of which have since been abandoned because of inefficacy or toxicity. Despite these limited treatment options, the authors reported seizure remission in 32% of pediatric patients with epilepsy, and seizure reduction in another 51%. Fifty years later, do today’s children fare better? (Source: The Journal of Pediatrics)

Use of anti-epileptic drugs in a tertiary care hospital of Eastern India with emphasis on epilepsy due to neurocysticercosis

Indian Journal of Pharmacology — Sat, 14 Jan 2012 05:00:00 +0100

Conclusion: Phenytoin is the primary antiepileptic in spite of its side effects; though addition of other anti-epileptic drugs (valproate, clobazam) was required for better seizure control. Cases of neurocysticercosis respond to anti-epileptic drugs without addition of anthelmintics. Side effects observed were mostly neurological in nature. (Source: Indian Journal of Pharmacology)

The science behind memory glitches

Guardian Unlimited Science — Sat, 14 Jan 2012 00:22:00 +0100

What is deja vu? And why do we sometimes enter a room only to forget why we're there? Christian Jarrett explains the science behind common memory misfitsDeja vuEach lived moment usually feels unique. But about two-thirds of us occasionally experience the fleeting sensation that life is on repeat. It's as if we've been in exactly the same place having exactly the same experience before, even though we know that's an impossibility.Known as deja vu (literally "already seen"), an early explanation was that the feeling arises from a delayed signal arriving from one of the eyes after a scene has already been processed by the brain. However, that idea was seemingly refuted by the case of a blind man who experienced deja vu.Modern theories focus on the memory process of familiarity, as distinct ...

[Non-convulsive status epilepticus in the 21st century: clinical characteristics, diagnosis, treatment and prognosis].

Revista de Neurologia — Fri, 13 Jan 2012 18:26:57 +0100

Authors: Gomez-Ibanez A, Urrestarazu E, Viteri C Abstract Non-convulsive status epilepticus is a significant issue for a neurologist because, despite its low prevalence, it mimics other pathologies, with therapeutics and prognostic outcomes. Diagnosis is based on clinical features, mainly mental status or impaired consciousness and electroencephalographic changes, so electroencephalogram is the first exploration we must perform with clinical suspicion. There are three clinical forms: generalized or absence status, with diffuse epileptiform discharges; focal, with epileptic discharges located in a specific brain area and may not affect consciousness; and subtle, with diffuse or local epileptic activity after a tonic-clonic seizure or convulsive status and limited or no motor activit...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Increased cortical BOLD signal anticipates generalized spike and wave discharges in adolescents and adults with idiopathic generalized epilepsies

Epilepsia — Fri, 13 Jan 2012 05:00:00 +0100

SummaryPurpose: Electroencephalography–functional magnetic resonance imaging (EEG‐fMRI) coregistration has recently revealed that several brain structures are involved in generalized spike and wave discharges (GSWDs) in idiopathic generalized epilepsies (IGEs). In particular, deactivations and activations have been observed within the so‐called brain default mode network (DMN) and thalamus, respectively. In the present study we analyzed the dynamic time course of blood oxygen level–dependent (BOLD) changes preceding and following 3 Hz GSWDs in a group of adolescent and adult patients with IGE who presented with absence seizures (AS). Our aim was to evaluate cortical BOLD changes before, during, and after GSWD onset.Methods: Twenty‐one patients with IGE underwent EEG‐fMR...

Pentylenetetrazole‐induced seizures cause acute, but not chronic, mTOR pathway activation in rat

Epilepsia — Fri, 13 Jan 2012 05:00:00 +0100

SummaryPurpose: The mammalian target of rapamycin (mTOR) pathway has been implicated in contributing to progressive epileptogenesis in models of chronic epilepsy. Conversely, seizures themselves may directly cause acute activation of the mTOR pathway. To isolate the direct effects of seizures on the mTOR pathway, the time course and mechanisms of mTOR activation were investigated with acute seizures induced by pentylenetetrazole (PTZ), which does not lead to chronic epilepsy.Methods: Western blot analysis was used to assay the phosphorylation of Akt and S6, as measures of activation of the phosphoinositide 3‐kinase (PI3K)/Akt and mTOR pathways, respectively, at various time points after PTZ‐induced seizures in rats. The ability of wortmannin, a PI3K inhibitor, to inhibit PTZ seiz...

Placebo‐corrected efficacy of modern nonenzyme‐inducing AEDs for refractory focal epilepsy: Systematic review and meta‐analysis

Epilepsia — Fri, 13 Jan 2012 05:00:00 +0100

SummaryPurpose: Given serious concerns over the adverse effects of enzyme induction, modern nonenzyme‐inducing antiepileptic drugs (AEDs) may be preferable, provided they have similar efficacy as enzyme‐inducing AEDs. This is currently unclear.Methods: Therefore, we performed a meta‐analysis of the evidence to determine the placebo‐corrected efficacy of adjunctive treatment with modern nonenzyme‐inducing AEDs versus modern enzyme‐inducing AEDs that are on the market for refractory focal epilepsy.Key Findings: Of 322 potentially eligible articles reviewed in full text, 129 (40%) fulfilled eligibility criteria. After excluding 92 publications, 37 studies dealing with a total of 9,860 patients with refractory focal epilepsy form the basis for the evidence. The overall wei...

How good are we at diagnosing seizures based on semiology?

Epilepsia — Fri, 13 Jan 2012 05:00:00 +0100

SummaryThe accuracy of visual diagnosis of seizures based on semiologic features among different health care professionals is largely unknown. We evaluated the ability of health care professionals to correctly diagnose epileptic seizures (ES) and psychogenic nonepileptic seizures (PNES) from a random selection of 10 ES and 10 PNES videos. The 20 videos (without accompanying electroencephalography) were shown only once, in a random mix to different groups of health care professionals. These individuals, blinded to the diagnosis, were asked to classify the seizure as ES or PNES. We used summary receiver operating characteristic (SROC) curves to determine the accuracy for each group. Next we calculated the difference between the area under the curve (AUC) of SROC between neurologists (as the ...

The new ILAE report on terminology and concepts for the organization of epilepsies: Critical review and contribution

Epilepsia — Fri, 13 Jan 2012 05:00:00 +0100

SummaryThis critical review refers to the new report on terminology and concepts for the organization of epilepsies by the Commission of the International League Against Epilepsy (ILAE). It is unfortunate that most of the proposals in the Commission’s report are modified interpretations and nomenclature of previous ILAE classifications; new terms are not better than the old ones, and recent advances have not been incorporated. Hence, the new ILAE report met with considerable dissatisfaction from several expert epileptologists. The Commission abandoned (1) the disease‐syndrome distinction, although “disease” is generally differentiated from “syndrome” in most medical texts as well as in the ILAE classification itself; (2) the distinction of “generalized” and “focal” for ...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Epilepsy control following intracranial monitoring without resection in young children

Epilepsia — Fri, 13 Jan 2012 05:00:00 +0100

We describe a cohort of patients with improved seizure control following IM without resective surgery.Methods: Over 12.5 years, 161 children underwent 496 surgeries including intracranial monitoring. We retrospectively reviewed the patients’ charts, operative reports, and radiologic scans, under an institutional review board–approved protocol.Key Findings: Seventeen patients underwent only IM, without additional resective surgery, and seven had a dramatic improvement in their epilepsy; six of the seven patients are seizure‐free (Engel class I), and one rarely has seizures (Engel class II). All seven patients had frequent seizures that led to IM: either daily (five patients) or 1–2 per week (two patients). The mean age (± standard deviation, SD) at seizure onset was 1.6 �...

Genome‐wide linkage meta‐analysis identifies susceptibility loci at 2q34 and 13q31.3 for genetic generalized epilepsies

Epilepsia — Fri, 13 Jan 2012 05:00:00 +0100

SummaryPurpose: Genetic generalized epilepsies (GGEs) have a lifetime prevalence of 0.3% with heritability estimates of 80%. A considerable proportion of families with siblings affected by GGEs presumably display an oligogenic inheritance. The present genome‐wide linkage meta‐analysis aimed to map: (1) susceptibility loci shared by a broad spectrum of GGEs, and (2) seizure type–related genetic factors preferentially predisposing to either typical absence or myoclonic seizures, respectively.Methods: Meta‐analysis of three genome‐wide linkage datasets was carried out in 379 GGE‐multiplex families of European ancestry including 982 relatives with GGEs. To dissect out seizure type–related susceptibility genes, two family subgroups were stratified comprising 235 families wit...

Attention‐deficit/hyperactivity disorder in childhood epilepsy: A neuropsychological and functional imaging study

Epilepsia — Fri, 13 Jan 2012 05:00:00 +0100

SummaryPurpose: Children with epilepsy have a significant risk for attention‐deficit/hyperactivity disorder (ADHD), which is often accompanied by deficits in working memory performance. However, it is not yet clear whether there are specific differences in the underlying mechanisms of working memory capability between children with epilepsy‐related ADHD and those with developmental ADHD. There is evidence that methylphenidate can improve the behavioral difficulties in children with developmental ADHD. Whether this medication has the same effect on ADHD symptoms in patients with epilepsy is not yet well understood. The aim of the present study is, therefore, to evaluate whether boys with epilepsy‐related ADHD and developmental ADHD share a common behavioral, pharmacoresponsive, and...

SSRIs raise risk of rare neonatal hypertension

OnMedica Latest News — Fri, 13 Jan 2012 05:00:00 +0100

Higher risk of persistent pulmonary hypertension for babies whose mothers took SSRIsRelated items from OnMedicaPregnancy raises risk of critical illness with swine fluNew warning on epilepsy drugs in pregnancyAntibiotic fails to improve lung function in children with CFWomen with small babies can safely wait for labourMore concern over paracetamol link to asthma (Source: OnMedica Latest News)

Structural magnetic resonance imaging in epilepsy.

Radiologia — Fri, 13 Jan 2012 05:00:00 +0100

Authors: Alvarez-Linera Prado J Abstract Magnetic resonance imaging is the main structural imaging in epilepsy. In patients with focal seizures, detection (and characterization) of a structural lesion consistent with electroclinical data allows therapeutic decisions without having to resort to other more expensive or invasive diagnostic procedures. The identification of some lesions may provide prognostic value, as in the case of Mesial Temporal Sclerosis (MTS) or may contribute to genetic counseling, as in the case of some Malformations of Cortical Development (MCD). The aim of this paper is to review the current state of structural MRI techniques, propose a basic protocol of epilepsy and mention the indications for structural MRI. Also, review the semiology of the main causes of ...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Stem cells as a potential therapy for epilepsy.

Experimental Neurology — Fri, 13 Jan 2012 05:00:00 +0100

This article reviews some of the major types of NSC/NPs and how they have been studied with regard to synaptic integration into host brain circuits. It also reviews how these transplanted cells develop and interact with host brain cells in animal models of epilepsy. The field is still wide open with a number of very promising results but there are also some major challenges that will need to be addressed prior to considering clinical applications for epilepsy. PMID: 22265818 [PubMed - as supplied by publisher] (Source: Experimental Neurology)

Calcified neurocysticercosis lesions and hippocampal sclerosis: Potential dual pathology?

Epilepsia — Fri, 13 Jan 2012 05:00:00 +0100

SummaryIn areas where cysticercosis is endemic, calcified neurocysticercosis lesion(s) (CNL) and hippocampal sclerosis (HS) commonly coexist in patients with localization‐related epilepsies. To understand the pathogenesis of HS associated with CNL, we compared the characteristics of three groups of patients with antiepileptic drug–resistant epilepsies: CNL with HS, CNL without HS (CNL alone), and HS without CNL (HS alone). In comparison to patients with CNL alone, those with CNL with HS had CNL more frequently located in the ipsilateral temporal lobe. Those with CNL with HS had a lower incidence of febrile seizures, older age at initial precipitating injury and at onset of habitual complex partial seizures, and more frequent clustering of seizures and extratemporal/bitemporal intericta...

Epilepsy Cases in Pregnant and Postpartum WomenEpilepsy Cases in Pregnant and Postpartum Women

Medscape Today Headlines — Fri, 13 Jan 2012 04:00:00 +0100

Many women with epilepsy require treatment during pregnancy, but many antiepileptic drugs are potential teratogens. This case series explores the best management for the pregnant epileptic patient. Seminars in Neurology (Source: Medscape Today Headlines)

[Differential diagnosis of epileptic seizures.]

Der Nervenarzt — Thu, 12 Jan 2012 05:00:00 +0100

We present the most common differential diagnoses and their differences compared to epileptic seizures. PMID: 22237650 [PubMed - as supplied by publisher] (Source: Der Nervenarzt)

[Epilepsy surgery.]

Der Nervenarzt — Thu, 12 Jan 2012 05:00:00 +0100

Authors: Noachtar S, Rémi J Abstract Epilepsy surgery is an important therapeutic option for patients with epilepsy since one third of all epilepsy patients will still not be become seizure free despite newly developed antiepileptic drugs. Anterior temporal lobe resection is the most common procedure. Extratemporal resections require more complex diagnostics and often invasive evaluation which is not the case in most temporal epilepsy patients due to improved imaging (MRI, PET, SPECT). Electrical stimulation of the anterior thalamus has been available as a treatment option since last year. PMID: 22237649 [PubMed - as supplied by publisher] (Source: Der Nervenarzt)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Quality-of-Life Measures in Children With Neurological Conditions: Pediatric Neuro-QOL

Neurorehabilitation and Neural Repair — Thu, 12 Jan 2012 05:00:00 +0100

Conclusions. The pediatric Neuro-QOL is a comprehensive measurement system with acceptable psychometric properties that could be used in computerized adaptive testing. The next step is to validate these measures in various clinical populations. (Source: Neurorehabilitation and Neural Repair)

Tumor necrosis factor-alpha-mediated threonine 435 phosphorylation of p65 nuclear factor-kappaB subunit in endothelial cells induces vasogenic edema and neutrophil infiltration in the rat piriform cortex following status epilepticus

Journal of Neuroinflammation — Thu, 12 Jan 2012 05:00:00 +0100

Conclusion: These findings suggest that impairments of endothelial cell functions via TNF-alpha-mediated p65-Thr 485 NF-kappaB phosphorylation may be involved in SE-induced vasogenic edema. Subsequently, vasogenic edema results in extensive neutrophil infiltration and neuronal-astroglial loss. (Source: Journal of Neuroinflammation)

NICE issues clinical guideline on the diagnosis and management of the epilepsy in adults and children in primary and secondary care

NeLM - Guidelines — Thu, 12 Jan 2012 05:00:00 +0100

Source: NICE Area: Evidence > Guidelines NICE has published a clinical guideline (CG137) offering evidence-based advice on the care and treatment of children, young people and adults with epilepsy. New recommendations have been added for the pharmacological treatment of people with epilepsy, including the use of a ketogenic diet. This clinical guideline updates and replaces NICE clinical guideline 20, published in 2004. It also updates and replaces NICE technology appraisal 76 (2004) and NICE technology appraisal 79 (2004 (Source: NeLM - Guidelines)

Genotype-phenotype correlation in CC2D2A-related Joubert syndrome reveals an association with ventriculomegaly and seizures

Journal of Medical Genetics — Thu, 12 Jan 2012 05:00:00 +0100

Conclusions CC2D2A testing should be prioritised in patients with JS and ventriculomegaly and/or seizures. Patients with CC2D2A-related JS should be monitored for hydrocephalus and seizures. (Source: Journal of Medical Genetics)

Dynamics of hemispheric dominance for language assessed by magnetoencephalographic imaging

Annals of Neurology — Thu, 12 Jan 2012 05:00:00 +0100

AbstractObjective:The goal of the current study was to examine the dynamics of language lateralization using magnetoencephalographic (MEG) imaging, to determine the sensitivity and specificity of MEG‐imaging, and to determine if MEG‐imaging can become a viable alternative to the intracarotid amobarbital procedure (IAP), the current gold‐standard for preoperative language lateralization in neurosurgical candidates.Methods:MEG was recorded during an auditory verb‐generation task and imaging analysis of oscillatory activity was initially performed in 21 subjects with epilepsy, brain tumor, or arteriovenous malformation who had undergone IAP and MEG. Time‐windows and brain regions‐of‐interest that best discriminated between IAP determined left or right dominant for language were ...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Diagnostic challenge in neuropsychiatry: two case reports

Central European Journal of Medicine — Wed, 11 Jan 2012 06:57:45 +0100

Conclusion Contemporary medical science could show improved outcomes not only by fragmenting into smaller specialized pieces, but also associating into bigger units, especially in the case of psychiatry. However, more exhaustive research should be provided to confirm such necessity Content Type Journal ArticleCategory Case ReportPages 1-6DOI 10.2478/s11536-011-0141-yAuthors Rytis Leonavičius, Department of Psychiatry of Medical Academy, Lithuanian University of Health Sciences, Eiveniu st. 2, Kaunas, LT-50009 Republic of LithuaniaVirginija Adomaitienė, Department of Psychiatry of Medical Academy, Lithuanian University of Health Sciences, Eiveniu st. 2, Kaunas, LT-50009 Republic of Lithuania Journal Central European Journal of MedicineOnline ISSN 1644-3640Pr...

Question 1 Do febrile convulsions cause CSF pleocytosis?

Archives of Disease in Childhood — Wed, 11 Jan 2012 05:00:00 +0100

Scenario You are asked to review a previously healthy 11-month-old boy who presented to the Accident and Emergency department following a generalised convulsion lasting 7 min. His parents tell you that he was started on oral amoxicillin by his general practitioner 2 days ago, the reason for which is unclear. Clinical examination reveals a drowsy child with a temperature of 38.8°C. In the absence of a clear focus of infection you decide to do a full septic screen, including a lumbar puncture (LP). Cerebrospinal fluid (CSF) analysis shows a white blood cell count (WCC) of 17x106/l, a protein concentration within normal limits and no bacteria on a Gram stain. You wonder if the mild CSF pleocytosis indicates partially treated meningitis or can be attributed to the convulsion alone. Structu...

It is all in the history, or is it?

Archives of Disease in Childhood - Education and Practice — Wed, 11 Jan 2012 05:00:00 +0100

‘Presentation—3 years old’ Alice is referred by her general practitioner (GP) for a paediatric neurology opinion with a history of episodes of her legs giving way. The referral letter from her GP mentions that when Alice is picked up when she has one of these episodes, she cannot control her legs, which move abnormally. Alice is seen by the registrar. Her parents' say that these episodes are occurring at a frequency of one every month, and they describe non-rhythmic jerky movements involving her legs lasting approximately 20 min. She falls and cannot walk or stand when these happen. Recovery occurs without intervention. She has experienced a total of five episodes, and they all occurred in the evening following exertion. Her consciousness is not impaired during these even...

BACE1 elevation is associated with aberrant limbic axonal sprouting in epileptic CD1 mice.

Experimental Neurology — Wed, 11 Jan 2012 05:00:00 +0100

Authors: Yan XX, Cai Y, Zhang XM, Luo XG, Cai H, Rose GM, Patrylo PR Abstract The brain is capable of remarkable synaptic reorganization following stress and injury, often using the same molecular machinery that governs neurodevelopment. This form of plasticity is crucial for restoring and maintaining network function. However, neurodegeneration and subsequent reorganization can also play a role in disease pathogenesis, as is seen in temporal lobe epilepsy and Alzheimer's disease. β-Secretase-1 (BACE1) is a protease known for cleaving β-amyloid precursor protein into β-amyloid (Aβ), a major constituent in amyloid plaques. Emerging evidence suggests that BACE1 is also involved with synaptic plasticity and nerve regeneration. Here we examined whether BACE1 immunoreactivity (IR) w...

Cannabis, possible cardiac deaths and the coroner in Ireland

Irish Journal of Medical Science — Tue, 10 Jan 2012 06:41:30 +0100

Conclusions To attribute sudden cardiac death to cannabis, plasma THC should be measured in the toxicology screen in coroners’ cases where urine cannabinoids are positive. A positive urine cannabinoids immunoassay alone is insufficient evidence in the linkage of acute cardiac death and cannabis. Content Type Journal ArticleCategory Original ArticlePages 1-4DOI 10.1007/s11845-011-0802-5Authors W. P. Tormey, Department of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, UK Journal Irish Journal of Medical ScienceOnline ISSN 1863-4362Print ISSN 0021-1265 (Source: Irish Journal of Medical Science)

MedWorm Sponsor Message: Find the best January Sales in the UK.

The Prevalence of Epilepsy in the Nakhichevan Autonomous Republic of Azerbaijan.

CNS and Neurological Disorders Drug Targets — Tue, 10 Jan 2012 05:00:00 +0100

Authors: Magalov SI, Hasanov NF, Azizova NX, Novruzov AN, Mustafayev ZB, Kazimov SA, Sultanov SS, Hasanov EN, Aliev G Abstract Epilepsy is a devastating neurological disorder in which those afflicted can gain benefit from specific treatments based on their genetics and geographic location. Currently the prevalence of epilepsy is estimated at 0.5-3% of the world-wide population, and is increasing in developing countries. In order to make more accurate assessments of the prevalence of epilepsy, we applied the capture-recapture method in a 12-month study of epilepsy in a population from the Sharur district of Nakhichevan Autonomous Republic, Azerbaijan with 114,451 people from sixty-nine villages and towns. The following methods were applied to determine epilepsy: Door To Door (DTD) s...

Brivaracetam Disposition in Renal Impairment.

The Journal of Clinical Pharmacology — Tue, 10 Jan 2012 05:00:00 +0100

The objective was to characterize its disposition in patients with renal impairment. A single oral dose of 200 mg brivaracetam was administered to 9 patients with severe renal impairment not requiring dialysis (creatinine clearance <15 mL/min, n = 6; 15-29 mL/min, n = 3) and 9 matched healthy controls. Plasma and urinary concentrations of brivaracetam and 3 pharmacologically inactive metabolites (acid, hydroxy, and hydroxyacid) were determined up to 72 hours postdose, and noncompartmental pharmacokinetic parameters were derived. The C(max) of brivaracetam was unchanged relative to healthy controls, whereas AUC was slightly increased (mean ratio, 1.21; 90% confidence interval, 1.01-1.45). Nonrenal and renal clearances of brivaracetam decreased from 47 and 4.5 to 41 and 1.7 mL/min/1.73 m(...

Using personality disorders to distinguish between patients with psychogenic nonepileptic seizures and those with epileptic seizures.

Epilepsy and Behaviour — Tue, 10 Jan 2012 05:00:00 +0100

Authors: Direk N, Kulaksizoglu IB, Alpay K, Gurses C Abstract Identifying psychiatric disorders rather than psychiatric symptoms might help to distinguish patients with psychogenic nonepileptic seizures (PNES) from those with epileptic seizures (ES). Patients with PNES (n=35), patients with ES (n=35), and healthy controls (n=37) were compared with respect to the prevalence of psychiatric disorders in this study. We tested the predictive power of having axis I psychiatric disorders, as well as personality disorders, in distinguishing ES from PNES. There was no significant difference between the patient groups in the prevalence of axis I psychiatric disorders. Personality disorders were more prevalent in the PNES group than in the ES group (P<0.05). Having a personality disorder w...

[Dravet syndrome as a cause of epilepsy and learning disability].

Tidsskrift for den Norske Laegeforening — Tue, 10 Jan 2012 05:00:00 +0100

We present a review of the genetic and clinical picture along with treatment aspects. Material and methods. This review is based on a non-systematic literature search in PubMed until April 2011 and the personal experiences of the authors. Results. Dravet syndrome should be suspected in children with febrile hemiconvulsions or tonic-clonic seizures in the first year of life. Non-febrile seizures also occur, and other seizure types gradually appear, e.g. myoclonic jerks, atypical absences or focal seizures. In adulthood the clinical picture is less characteristic. The clinical diagnosis is supported by genetic testing; 70-80% of the patients have mutations in the sodium channel subunit gene SCN1A. Seizure control is difficult to achieve, but valproate, benzodiazepines and stiripentol may cau...

Protein changes identified in early-onset Alzheimer's

UCLA Newsroom: Health Sciences — Mon, 09 Jan 2012 21:00:00 +0100

In this study, we've identified chemical changes occurring in the brains of persons destined to develop Alzheimer's disease 10 years or more prior to the expression of symptoms. By studying the cerebrospinal fluid of persons developing Alzheimer's disease at a relatively young age with cutting-edge protein chemical techniques, we found changes in markers reflecting inflammation as well as the breakdown of synapses. "This provides potential new targets for drug interventions, and it helps elucidate the degree to which FAD and late-onset Alzheimer's are similar and to what degree they are distinct. Such knowledge may ultimately allow us to tailor our treatments to individuals, depending on the 'type' of Alzheimer's they have." The study, funded in part by the pharmaceutical com...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

A novel kynurenic acid analog (SZR104) inhibits pentylenetetrazole-induced epileptiform seizures. An electrophysiological study

Journal of Neural Transmission — Mon, 09 Jan 2012 19:35:20 +0100

Abstract The concentration of kynurenic acid (KYNA) in the cerebrospinal fluid, which is in the nanomolar range, is known to decrease in epilepsy. The experimental data suggest that treatment with l-KYN dose dependently increases the concentration of the neuroprotective KYNA in the brain, which itself hardly crosses the blood–brain barrier. However, it is suggested that new synthetic KYNA analogs may readily cross the blood–brain barrier. In this study, we tested the hypothesis that a new KYNA analog administered systemically in a sufficient dose results in a decreased population spike activity recorded from the pyramidal layer of area CA1 of the hippocampus, and also provides protection against pentylenetetrazole-induced epileptiform seizures. Content Type Journal...

Hyperinsulinaemic hypoglycaemia: genetic mechanisms, diagnosis and management

Journal of Inherited Metabolic Disease — Mon, 09 Jan 2012 19:34:52 +0100

Abstract Hyperinsulinaemic hypoglycaemia (HH) is due to the unregulated secretion of insulin from pancreatic β-cells. A rapid diagnosis and appropriate management of these patients is essential to prevent the potentially associated complications like epilepsy, cerebral palsy and neurological impairment. The molecular basis of HH involves defects in key genes (ABCC8, KCNJ11, GLUD1, GCK, HADH, SLC16A1, HNF4A and UCP2) which regulate insulin secretion. The most severe forms of HH are due to loss of function mutations in ABCC8/KCNJ11 which encode the SUR1 and KIR6.2 components respectively of the pancreatic β-cell KATP channel. At a histological level there are two major forms (diffuse and focal) each with a different genetic aetiology. The diffuse form is inherited in an autos...

Familial clustering of epilepsy and behavioral disorders: Evidence for a shared genetic basis. - Hesdorffer DC, Caplan R, Berg AT.

SafetyLit: All (Unduplicated) — Mon, 09 Jan 2012 12:09:00 +0100

Purpose: To examine whether family history of unprovoked seizures is associated with behavioral disorders in epilepsy probands, thereby supporting the hypothesis of shared underlying genetic susceptibility to these disorders. Methods: We conducted an... (Source: SafetyLit: All (Unduplicated))

Risk of violent crime in individuals with epilepsy and traumatic brain injury: a 35-year Swedish population study. - Fazel S, Lichtenstein P, Grann M, Langstrom N.

SafetyLit: All (Unduplicated) — Mon, 09 Jan 2012 12:09:00 +0100

BACKGROUND: Epilepsy and traumatic brain injury are common neurological conditions, with general population prevalence estimates around 0.5% and 0.3%, respectively. Although both illnesses are associated with various adverse outcomes, and expert opinion ha... (Source: SafetyLit: All (Unduplicated))