MedWorm: Epilepsy

The circadian rhythm and its interaction with human epilepsy: A review of literature

Sleep Medicine Reviews — Fri, 06 Nov 2009 16:10:23 +0100

Summary: Knowledge on the interaction between circadian rhythm and human epilepsy is relatively poor, although if it exists, this interaction may be of value for better knowledge of pathophysiology and for timing of diagnostic procedures and therapy. It appears that human seizure occurrence may have 24-h rhythmicity, depending on the origin. These findings are endorsed by animal studies. Rats placed in constant darkness showed spontaneous limbic seizures occurring in an endogenously mediated circadian pattern. More studies are available on the influence of epilepsy on circadian rhythms. Significant differences in chronotypes between patients with different epilepsy syndromes have been found and numerous studies have described influences of epilepsy and seizures on sleep. In contrast, knowl...

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Antiepileptic drug retigabine filed for approval in EU and US

NeLM - News — Thu, 05 Nov 2009 00:00:00 +0100

Source: PharmaTimes Area: News GlaxoSmithKline and Valeant Pharmaceuticals International have filed their investigational treatment retigabine for marketing approval in the EU and the US, as adjunctive therapy to treat adult epilepsy patients with partial-onset seizures. Retigabine is neuronal potassium channel opener. (Source: NeLM - News)

Recurrent Seizures Related to Motor Cortex Stimulator Programming

Neuromodulation — Thu, 05 Nov 2009 00:00:00 +0100

Conclusions. Despite the overall safety of MCS for the treatment of chronic pain, seizures during and after programming are a serious risk that should be anticipated. In this group of patients, seizures were associated only with stimulus rates between 70 and 90 Hz. No patient developed chronic epilepsy from the stimulation. (Source: Neuromodulation)

Brooklyn girl winds up in hospital after being injected with H1N1 swine flu vaccine without parental permission

NaturalNews.com — Wed, 04 Nov 2009 07:00:00 +0100

(NaturalNews) A six-year-old Brooklyn girl, Nikiyah Torres-Pierre, was hospitalized recently after being injected with the swine flu vaccine. The vaccination was conducted entirely without her parents' permission in an incident school nurses are calling "a mistake."Mother Naomi Troy told the NY Daily News, "I was outraged." After receiving the swine flu injection, her daughter complained she was itching and her stomach was hurting. That's when school officials called an ambulance that rushed Nikiyah to the hospital.Nikiyah is epileptic and takes prescription medication to treat the condition. Her mother was concerned about the possible side effects of combining a swine flu vaccine shot with epilepsy drugs and was waiting to hear back from her doctor before giving the school permission to v...

Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies

Epilepsia — Wed, 04 Nov 2009 00:00:00 +0100

To improve patient care and facilitate clinical research, the International League Against Epilepsy (ILAE) appointed a Task Force to formulate a consensus definition of drug resistant epilepsy. The overall framework of the definition has two "hierarchical" levels: Level 1 provides a general scheme to categorize response to each therapeutic intervention, including a minimum dataset of knowledge about the intervention that would be needed; Level 2 provides a core definition of drug resistant epilepsy using a set of essential criteria based on the categorization of response (from Level 1) to trials of antiepileptic drugs. It is proposed as a testable hypothesis that drug resistant epilepsy is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic d...

Alzheimer’s Disease and Neuronal Network Activity

NeuroMolecular Medicine — Tue, 03 Nov 2009 11:07:15 +0100

Abstract The amyloid β-peptide theory of Alzheimer’s Disease has helped to advance our understanding of the disease tremendously. A new area of research focuses on the changes in neuronal network activity that take place and may contribute to the clinical and pathological picture of Alzheimer’s Disease. An apparent symptom of altered neuronal network activity in Alzheimer’s Disease is an increased frequency in epileptic seizures that is observed both in human patients and in mouse models of Alzheimer’s Disease. A root cause for altered network activity may be amyloid β itself by its ability to alter synaptic (glutamatergic) transmission and to impair the induction of long-term potentiation. It is on this aspect of Alzheimer’s Disease research that the current i...

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Micrographia and hypophonia in anorexia nervosa

International Journal of Eating Disorders — Tue, 03 Nov 2009 00:00:00 +0100

Micrographia is a condition, in which the sufferers write with small handwriting. Hypophonia is described as low volume speech. Both conditions have been described in neurological conditions, such as lesions in the deep white matter of the brain, Parkinson's disease etc., In this case report, we are presenting a 22-years-old female patient with anorexia nervosa who suffered from both these conditions. The patient also suffered from epilepsy. The onset of these symptoms, progress, and current status provides scope for discussing both the possible biological and psychodynamic etiology for these symptoms in this young woman. © 2009 by Wiley Periodicals, Inc. (Source: International Journal of Eating Disorders)

Ictal affective symptoms in temporal lobe epilepsy are related to gender and age

Epilepsia — Tue, 03 Nov 2009 00:00:00 +0100

Discussion: Patient-reported and video-recorded negative[mdash]but not positive[mdash]affective signs are related to each other. Video-recorded negative AAs occur more often in women and young patients. (Source: Epilepsia)

Topiramate overdose: A case report of a patient with extremely high topiramate serum concentrations and nonconvulsive status epilepticus

Epilepsia — Tue, 03 Nov 2009 00:00:00 +0100

We report the case of a 21-year-old man with idiopathic generalized epilepsy who ingested about 8,000 mg of topiramate (TPM) in a suicide attempt. On admission to the hospital he had a nonconvulsive status epilepticus and received 4 mg lorazepam i.v. He recovered rapidly despite an initial TPM concentration of 144.6 [mu]g/ml. To our knowledge, this is the first report of a patient who survived such a high TPM concentration. The case indicates that nonconvulsive status epilepticus could be a manifestation of TPM intoxication. (Source: Epilepsia)

Basal hypercortisolism and trauma in patients with psychogenic nonepileptic seizures

Epilepsia — Tue, 03 Nov 2009 00:00:00 +0100

Discussion: This is the first study showing that basal hypercortisolism in patients with PNES is independent of the acute occurrence of seizures. In addition, basal hypercortisolism was more pronounced in traumatized patients with PNES as compared to nontraumatized patients with PNES. These findings suggest that HPA-axis activity provides a significant neurobiologic marker for PNES. (Source: Epilepsia)

Using the Internet to recruit patients for epilepsy trials: Results of a New Zealand pilot study

Epilepsia — Tue, 03 Nov 2009 00:00:00 +0100

Discussion: We have demonstrated that patients can be recruited for trials and randomized from routine clinics via the Internet. Trials could compare AEDs or look at other aspects of epilepsy management. An international pilot study is planned. Neurologists are invited to enroll patients with epilepsy, who would be suitable for randomized controlled trials, into a Web-based register. (Source: Epilepsia)

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Profiles of psychosocial outcome after epilepsy surgery: The role of personality

Epilepsia — Tue, 03 Nov 2009 00:00:00 +0100

Discussion: Psychosocial outcome after epilepsy surgery appears intrinsically linked to a change in self and a transition from chronically sick to well. The development of personality traits and self-identity in the context of habitual seizures can impact psychosocial outcome and the extent of self-change reported after surgery, and paradoxically, can concur more beneficial effects. (Source: Epilepsia)

Psychiatric comorbidity and suicidal behavior in epilepsy: A community-based case–control study

Epilepsia — Tue, 03 Nov 2009 00:00:00 +0100

Conclusions: These findings call attention to psychiatric comorbidity and suicidal behavior associated with epilepsy. Suicide risk assessment, mental evaluation, and treatment may improve quality of life in epilepsy and ultimately prevent suicide. (Source: Epilepsia)

Levetiracetam inhibits glutamate transmission through presynaptic P/Q-type calcium channels on the granule cells of the dentate gyrus

British Journal of Pharmacology — Tue, 03 Nov 2009 00:00:00 +0100

Conclusions and implications: These results suggest that levetiracetam modulated the presynaptic P/Q-type voltage-dependent calcium channel to reduce glutamate release and inhibited the amplitude of EPSC in DG. This effect is most likely to contribute to the anti-epileptic action of levetiracetam in patients. (Source: British Journal of Pharmacology)

Cognitive Impairments at Onset of Epilepsy

AAP Grand Rounds — Mon, 02 Nov 2009 16:01:24 +0100

(Source: AAP Grand Rounds)

Retigabine Regulatory Update

GSK news — Mon, 02 Nov 2009 13:00:00 +0100

GlaxoSmithKline (GSK) and Valeant Pharmaceuticals International (VRX) announced today that, on 30 October, they filed a New Drug Application with the US Food and Drug Administration (FDA) and a Marketing Authorisation Application (MAA) with the European Medicines Agency (EMEA), for retigabine, used as adjunctive therapy to treat adult epilepsy patients with partial-onset seizures (Source: GSK news)

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Tapeworm link with epilepsy 'far higher' than thought

SciDev.Net — Mon, 02 Nov 2009 03:34:58 +0100

Pork tapeworm is responsible for almost a third of epileptic fits, researchers say. (Source: SciDev.Net)

What Evaluation is Appropriate for Complex Febrile Seizures?

PediatricEducation.org — Mon, 02 Nov 2009 00:23:48 +0100

Discussion Febrile seizures are the most common type of seizures in children. They affect about 2-5% of all children. Febrile seizures are characterized into two groups: simple febrile seizures and complex febrile seizures. Basically, if the child does not meet the criteria for a simple febrile seizure it is called a complex febrile seizure. The main characteristics are outlined below: Simple Febrile Seizure Complex Febrile Seizure Age 6-60 months < 6 months or > 60 months Duration < 15 minutes > 15 minutes Type Generalized Focal seizures tonic-clonic Tonic and/or clonic Partial seizure with/without generalization Head or eye deviation to one side Unilateral transient paralysis after seizure Loss of musc...

Involuntary Emotional Expression Disorder

Psych Central — Sun, 01 Nov 2009 19:59:53 +0100

, or IEED, is a condition in which a person experiences uncontrollable episodes of emotional expression. That is, they have episodes of crying, laughter, or anger that are not in line with their present mood. The condition is also known as labile affect, pseudobulbar affect, emotional lability, and pathological laughing and crying. It can have a severe impact on the lives of both patients and caregivers, as symptoms may leave sufferers feeling guilty, awkward, embarrassed and reluctant to take part in social interaction. IEED is seen most often following brain injury or in people with dementia, motor neuron disease, and multiple sclerosis. It can appear at any stage of the associated diseases. Its prevalence was estimated in 2007 by Walter Bradley, MD, of Miami University. His team survey...

This week on Thrive: Oct. 26 – 30

Thrive, Children's Hospital Boston — Sun, 01 Nov 2009 12:00:28 +0100

Here’s a look at what Thrive was up to last week. Frances Jensen, MD, senior associate in Neurology, was featured in a piece on 60 Minutes about the prevalence of epilepsy and the importance of funding research that can lead to its cure. It’s clearer than ever before: American children are suffering from a Vitamin D deficiency. A novel surgery saves one baby’s vision. The HealthMap team gives our weekly H1N1 update. Children’s doctors talk about how easily H1N1 spreads and Dr. Sanjay Gupta visits Children’s. Our Mediatrician tackles “s. lists” and a Children’s expert offers parents a guide to a healthful Halloween. Related posts:This week on Thrive: Oct. 5 – 9This week on Thrive: Oct. 19 – 23This week on Thrive: Oct. 12 – 16 (Source: Thrive, Children's H...

Pre-existing Health Conditions and Repeat Traumatic Brain Injury

Archives of Physical Medicine and Rehabilitation — Sun, 01 Nov 2009 00:00:00 +0100

Conclusions: Pre-existing epilepsy/seizure disorder predisposes to repeat TBI. Appropriate management of seizure control may be an important strategy to allay the occurrence of repeat TBI. (Source: Archives of Physical Medicine and Rehabilitation)

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Epilepsy, mental health, adults with learning disability – reviewing the evidence

Psychiatry — Sun, 01 Nov 2009 00:00:00 +0100

Abstract: Epilepsy, the experience of learning disability and the experience of mental health problems frequently occur in the same individual and can cause severe disadvantage, distress and vulnerability to the individual, together with a burden of care on families or carers. The challenges posed to clinicians include unpicking the complexities involved in understanding symptoms and presentations as well as the very limited evidence-based guiding management strategies. While evidence for service provision, care giving, and specific treatments is very limited, there are some themes that emerge from a review of the literature. The evidence that does exist indicates that the combination of these experiences is common, and attention must be paid to individual circumstances if one is to effect...

Assessment in primary care

Psychiatry — Sun, 01 Nov 2009 00:00:00 +0100

Abstract: For many people with learning disabilities, the presence of ill health may impair their ability to achieve the best possible quality of life. The attainment of a good standard of health (at least as good as the rest of the population) is a reasonable goal. Primary care teams are central to the provision of good-quality healthcare. This provision is based on an ability to assess, investigate and manage a range of common and complex conditions, which requires an awareness of the specific needs of this population. The expected health needs of people with learning disabilities in the community and how best to identify and address these needs are described here. These needs include improved access to health promotion, identification of common but unidentified illness and the common co...

Editorial Board

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

(Source: Epilepsy Research)

Ischaemic stroke in adults and epilepsy

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Summary: Stroke is an important cause of symptomatic epilepsy especially in the elderly. Seizures in the setting of stroke will furthermore worsen the prognosis of stroke. Studies show that the frequency of seizures in stroke ranges between 2.3% and 14%. Typically early seizures are defined as those that occur within 14 days of the stroke, and later seizures those that occur after this period. A number of risk factors have been identified like cortical involvement, size of the infarct and stroke severity. Status epilepticus can be a presenting symptom of acute stroke and can lead to increased mortality. Early seizures are risks for recurrent seizures though not for the development of epilepsy but late seizures do carry a higher risk. There are no clear cut guidelines for the treatment of s...

Movement induces suppression of interictal spikes in sensorimotor neocortical epilepsy

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Summary: Epileptic activities are known to be modulated by cortical excitability, which is altered with normal brain functioning such as movement. However, the relationship between the epileptic activity and movement has not been well studied. Here, we investigated movement-induced modulation of interictal spikes to reveal the relationship between epileptic activity and the movement-induced modulation of cortical activity. Two patients (three cases) with focal cortical dysplasia (FCD) of the pre- and/or post-central gyrus performed voluntary movements of their hands or mouths. During the movement, the interictal spikes of the sensorimotor cortex, which were measured by electrocorticograms (ECoG), were significantly reduced. This reduction strongly correlated with the event-related desynchr...

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Intracranial EEG power and metabolism in human epilepsy

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Summary: EEG power and high frequency activity in the seizure onset zone has been increasingly considered for its relationship with seizures in animal and human studies of epilepsy. We examine the relationship between quantitative EEG measures and metabolic imaging in epilepsy patients undergoing intracranial EEG (icEEG) analysis for seizure localization. Patients with mesial temporal lobe epilepsy (MTLE) and neocortical epilepsy (NE) were studied. Metabolic imaging was performed with MR spectroscopic imaging using N-acetyl aspartate (NAA) and creatine (Cr). All data were acquired from the mesial temporal lobe such that a direct comparison of the same anatomical regions between the two groups could be performed. While no difference was seen in the total power recorded from the mesial tempo...

CDKL5 and ARX mutations are not responsible for early onset severe myoclonic epilepsy in infancy

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Summary: Background: Severe myoclonic epilepsy of infancy (SMEI) or Dravet syndrome (DS) is a distinctive epilepsy syndrome often associated with de novo mutations in the SCN1A gene. However, 25–30% patients with SMEI/DS are negative for SCN1A mutation screening, suggesting that other molecular mechanisms may account for these disorders. Given the overlapping and heterogeneous clinical features of CDKL5- and ARX-related epilepsies and SMEI/DS, we postulated that CDKL5 mutations in females and ARX mutations gene in males may be associated with early onset seizures forms of SMEI/DS.Methods: Twenty-eight patients with early onset SMEI/DS before 6 months negative for SCN1A mutational screening were selected and screened for mutations in the ARX gene in males (n=14) or the CDKL5 gene in femal...

Antiepileptic drugs in epilepsy and other disorders—A population-based study of prescriptions

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Summary: Purpose: The aim of the study was to quantify the use of antiepileptic drugs (AEDs) in epilepsy and other indications in a nation-wide population using a prescription database.Materials and methods: Prescription data of AEDs were collected from the Norwegian Prescription Database for the period 2004–2007, including 5.1 million prescriptions from 144,653 patients, all having at least one prescribed and dispensed AED. Diagnosis-related reimbursement codes were used as indicators for clinical use.Results: Of the AEDs used, 71% was in epilepsy, 15% in psychiatry, 13% in neuropathic pain, and (Source: Epilepsy Research)

Lack of laterality in the effects of right and left amygdala kindling on weight gain in female rats

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Conclusion: Amygdala kindling increases weight gain and serum leptin levels in rats, but in the present study no laterality effects were seen. (Source: Epilepsy Research)

Hemispherectomy-associated complications from the Kids’ Inpatient Database

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Conclusion: In-hospital mortality of HS is low, and blood transfusion was performed in over one third of patients. There appear to be several risk factors that can predict the likelihood of transfusion and may warrant close observation before hemispherectomy. (Source: Epilepsy Research)

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Is asymmetric dimethylarginine responsible for the vascular events in patients under antiepileptic drug treatment?

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

In conclusion our data suggest that elevated ADMA levels may be responsible for the increased cardiovascular risk in patients with epilepsy under AED therapy. (Source: Epilepsy Research)

Concordance of survey and billing data in a study of outpatient healthcare cost and utilization among epilepsy patients

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Summary: We assessed the concordance between healthcare utilization and cost measured with patient survey and billing data among 226 epilepsy patients in a large multi-specialty group practice. Does survey information on utilization combined with prices, provide a cost of care that is approximately equal to the cost of care derived from billing data, utilizing the same price structure? Do measures of cost from survey and billing data yield the same correlates of cost among epilepsy patients? If so, survey data may be utilized to estimate correlates and cost of epilepsy care in cases where complete billing information is not available.For five of eight outpatient services, the concordance coefficients exceeded the practical cut-off value for clinical studies, suggesting substantial agreemen...

Regional expression of Fos-like immunoreactivity following seizures in Noda epileptic rat (NER)

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Summary: Noda epileptic rat (NER) is a genetic rat model of epilepsy that exhibit spontaneous generalized tonic–clonic (GTC) seizures with paroxysmal discharges. We analyzed the regional expression of Fos-like immunoreactivity (Fos-IR) following GTC seizures in NER to clarify the brain regions involved in the seizure generation. GTC seizures in NER elicited a marked increase in Fos expression in the piriform cortex, perirhinal–entorhinal cortex, insular cortex and other cortices including the motor cortex. In the limbic regions, Fos-IR was highest in the amygdalar nuclei (e.g., basomedial amygdaloid nucleus), followed by the cingulate cortex and hippocampus (i.e., dentate gyrus and CA3). As compared to the above forebrain regions, NER either with or without GTC seizures exhibited only ...

Quantitative brain surface mapping of an electrophysiologic/metabolic mismatch in human neocortical epilepsy

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Summary: The spatial relationship between an intracranial EEG-defined epileptic focus and cortical hypometabolism on glucose PET has not been precisely described. In order to quantitatively evaluate the hypothesis that ictal seizure onset and/or rapid seizure propagation, detected by subdural EEG monitoring, commonly involves normometabolic cortex adjacent to hypometabolic cortical regions, we applied a novel, landmark-constrained conformal mapping approach in 14 children with refractory neocortical epilepsy. The 3D brain surface was parcellated into finite cortical elements (FCEs), and hypometabolism was defined using lobe- and side-specific asymmetry indices derived from normal adult controls. The severity and location of hypometabolic areas vs. ictal intracranial EEG abnormalities were ...

Giant subcortical heterotopia involving the temporo-parieto-occipital region: A challenging cause of drug-resistant epilepsy

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Summary: The clinical, radiological, neurophysiological and neuropsychological findings of three patients with giant subcortical heterotopia are reported.All patients experienced psychomotor and behaviour improvement after surgery. Two subjects are seizure-free after complete excision of the heterotopia; the third patient significantly improved following subtotal removal (Engel's class II).Patients affected by giant subcortical heterotopias can have a favourable prognosis after the surgical removal of the malformation, even following long-lasting epilepsy. (Source: Epilepsy Research)

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Supplementary implantation of intracranial electrodes in the evaluation for epilepsy surgery

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Conclusions: The addition of supplementary electrodes to an ongoing invasive electrode investigation can be a useful means of clarifying a patient's suitability for a resective surgical procedure. While the surgical outcomes may not be as favorable as in patients in whom the investigations are simpler, a proportion of these patients do benefit from the eventual resective procedure. In cases where the supplementary electrodes lead to the conclusion that surgery is not indicated, these patients can be satisfied that the surgical option has been explored to the fullest extent possible. (Source: Epilepsy Research)

Abnormal parieto-motor connectivity in Tuberous Sclerosis Complex

Epilepsy Research — Sun, 01 Nov 2009 00:00:00 +0100

Summary: Abnormal connectivity might be involved in the pathophysiology of Tuberous Sclerosis Complex (TSC). We used twin-coil Transcranial Magnetic Stimulation protocol to investigate connectivity between posterior parietal cortex (PPC) and motor cortex (M1) in TSC patients. In comparison with healthy subjects and TSC patients treated with antiepileptic drugs, non-medicated TSC patients exhibited abnormal excitability of PPC–M1 connection. Such altered connectivity might play a role in TSC epileptic phenotype. (Source: Epilepsy Research)

Oxcarbazepine: Lack of efficacy in epilepsy: case report

Reactions — Sat, 31 Oct 2009 14:02:00 +0100

(Source: Reactions)

Margiad Evans (1909-1958): A history of epilepsy in a creative writer.

Epilepsy and Behaviour — Sat, 31 Oct 2009 00:00:00 +0100

Authors: Larner AJ The author Margiad Evans (1909-1958), a celebrated Anglo-Welsh writer of the 1930s and 1940s, developed epilepsy in 1950, and subsequently wrote accounts of her experiences of seizures, their diagnosis, and their management. These documents are among the first patient accounts of epilepsy, and remain of value today, not least because they prefigure ongoing problems in epilepsy management such as pregnancy and the adverse effects of antiepileptic drugs. They also give some insights into the consequences of epilepsy for a creative writer. PMID: 19884046 [PubMed - as supplied by publisher] (Source: Epilepsy and Behaviour)

Status epilepticus with visual seizures in ketotic hyperglycemia.

Epilepsy and Behaviour — Sat, 31 Oct 2009 00:00:00 +0100

We describe the case of a 48-year-old man who presented with complex partial status epilepticus with visual seizures in the context of ketotic hyperglycemia. The EEG revealed a temporal epileptogenic focus and alterations were apparent on MRI in the acute phase and 4months later. Very few cases of seizures in ketotic patients have been reported because ketone bodies have a protective effect against epilepsy. Seizures in hyperglycemia tend to be partial, and the only reports of visual seizures were due to occipital foci. Neuroradiological alterations have been reported in epileptic seizures, although usually in generalized seizures. The clinical, electrical, and imaging characteristics of this case are interesting and suggest that partial seizures can also cause long-term neuronal damage. ...

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Encephalocraniocutaneous lipomatosis

Journal of Medical Genetics — Fri, 30 Oct 2009 17:02:04 +0100

Conclusions: Revised diagnostic criteria are proposed. ECCL is considered to differ from Proteus syndrome in particular, but oculoectodermal syndrome is possibly a mild variant. Pathogenetically, mosaicism for a mutated autosomal gene involved in multiple mesenchymal tumours and vasculogenesis, with or without a second hit event, is discussed. (Source: Journal of Medical Genetics)

The unfolding clinical spectrum of POLG mutations

Journal of Medical Genetics — Fri, 30 Oct 2009 17:02:04 +0100

Conclusion: The clinical features of the patient are the most important features to select putative POLG mutation carriers and not the presence of mtDNA deletions or OXPHOS (oxidative phosphorylation) activity. The authors conclude that POLG mutations are an important cause of heterogeneous mitochondrial pathology and that more accurate genotype–phenotype correlations allow a more rapid genetic diagnosis and improved prognosis for mutation carriers. (Source: Journal of Medical Genetics)

Sugar sulfamates for seizure control: discovery and development of topiramate, a structurally unique antiepileptic drug.

Current Topics in Medicinal Chemistry — Fri, 30 Oct 2009 15:50:06 +0100

This article discusses research results and events surrounding the discovery and development of topiramate. PMID: 19860705 [PubMed - in process] (Source: Current Topics in Medicinal Chemistry)

Announcement: National Epilepsy Awareness Month --- November 2009

CDC Morbidity and Mortality Weekly Report — Fri, 30 Oct 2009 13:40:28 +0100

(Source: CDC Morbidity and Mortality Weekly Report)

Molecular Basis of Reduced Pyridoxine 5'-Phosphate Oxidase Catalytic Activity in Neonatal Epileptic Encephalopathy Disorder [Protein Structure and Folding]

Journal of Biological Chemistry — Fri, 30 Oct 2009 13:37:01 +0100

Mutations in pyridoxine 5'-phosphate oxidase are known to cause neonatal epileptic encephalopathy. This disorder has no cure or effective treatment and is often fatal. Pyridoxine 5'-phosphate oxidase catalyzes the oxidation of pyridoxine 5'-phosphate to pyridoxal 5'-phosphate, the active cofactor form of vitamin B6 required by more than 140 different catalytic activities, including enzymes involved in amino acid metabolism and biosynthesis of neurotransmitters. Our aim is to elucidate the mechanism by which a homozygous missense mutation (R229W) in the oxidase, linked to neonatal epileptic encephalopathy, leads to reduced oxidase activity. The R229W variant is ~850-fold less efficient than the wild-type enzyme due to an ~192-fold decrease in pyridoxine 5'-phosphate affinity and an ~4.5-fol...

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Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25): Preliminary data for the Serbian version.

Epilepsy and Behaviour — Fri, 30 Oct 2009 00:00:00 +0100

The objectives of this study were to translate into Serbian the Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) and to provide preliminary data on its measurement properties. Translation, cultural adaptation, and pretesting were performed first, followed by evaluation of several reliability aspects of this version administered to 50 children with epilepsy and their parents. The mean scores of the CHEQOL-25 subscales ranged from 12.2 to 14.4 for children and from 12.4 to 15 for parents (possible range: 5-20). The internal consistency coefficients of the subscales ranged from 0.11 to 0.87. Between the children's and parents' reports, there was a moderate level of agreement (0.43-0.57). It was concluded that the Serbian version is a feasible measure, all subscale...

Human health risk assessment of carbamazepine in surface waters of North America and Europe.

Regulatory Toxicology and Pharmacology : RTP — Fri, 30 Oct 2009 00:00:00 +0100

Authors: Cunningham VL, Perino C, D'Aco VJ, Hartmann A, Bechter R A human health risk assessment was carried out for environmental exposures to carbamazepine (CBZ) and its major human metabolites, carbamazepine diol (CBZ-DiOH) and carbamazepine N-glucuronide (CBZ-N-Glu). Carbamazepine is an active pharmaceutical ingredient (API) used worldwide as a medicine for treating epileptic seizures and trigeminal neuralgia. Carbamazepine tends to be detected in surface water more frequently and at relatively higher concentrations, than most other APIs. Predicted no effect levels (PNECs) for CBZ and its major human metabolites were developed for surface waters to be protective of human health from environmental exposures from drinking water and fish consumption. These PNECs were compared to both ...

[The use of intravenous levetiracetam in a general hospital.]

Revista de Neurologia — Thu, 29 Oct 2009 21:09:02 +0100

CONCLUSIONS. Intravenous levetiracetam seems to be an effective, safe antiepileptic drug in hospitalised patients, and especially so in those who present an associated comorbidity and/or who are on multiple drug therapy. PMID: 19859874 [PubMed - in process] (Source: Revista de Neurologia)

[Genetics components in patients with temporal lobe epilepsy.]

Revista de Neurologia — Thu, 29 Oct 2009 21:08:51 +0100

CONCLUSION. The ELT is a complex disease and its development could depend on either genetics factors or other factors. Functional studies are necessary in order to correlate its molecular basis and their development. PMID: 19859879 [PubMed - in process] (Source: Revista de Neurologia)

[Tropical causes of epilepsy.]

Revista de Neurologia — Thu, 29 Oct 2009 21:08:26 +0100

CONCLUSIONS. Very few studies have been conducted to examine the prognosis, risk of recurrence and modification of the natural course of seizures associated with tropical parasitic infestations, except for the case of neurocysticercosis. PMID: 19859889 [PubMed - in process] (Source: Revista de Neurologia)

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[Cell and ex vivo gene therapy: advances in the treatment of central nervous system disorders.]

Revista de Neurologia — Thu, 29 Oct 2009 21:08:24 +0100

CONCLUSIONS. Ex vivo cell therapy and gene therapy have helped to expand our knowledge about plasticity and the mechanisms and factors that promote cell integration within the central nervous system. Although behavioural improvements have been reported in animal and human models, further work is still required on these studies to clear up a number of dubious points. Ex vivo cell therapy and gene therapy in the nervous system constitute an important methodological tool with therapeutic possibilities that deserve further study. PMID: 19859890 [PubMed - in process] (Source: Revista de Neurologia)

[Effectiveness of levetiracetam in a patient with chronic motor tics, rolandic epilepsy and attentional and behavioural disorder.]

Revista de Neurologia — Thu, 29 Oct 2009 21:08:14 +0100

Authors: Martin Fernandez-Mayoralas D, Fernandez-Jaen A, Munoz-Jareno N, Calleja-Perez B, Arroyo-Gonzalez R PMID: 19859894 [PubMed - in process] (Source: Revista de Neurologia)

Drug "may protect nerve cells"

Pharmacy Europe — Thu, 29 Oct 2009 14:08:08 +0100

A type of drug used to treat epilepsy may be able to protect nerve cells from damage, according to reports from the US. (Source: Pharmacy Europe)

Epilepsy Drugs Could Treat Alzheimer's And Parkinson's

ScienceDaily Headlines — Thu, 29 Oct 2009 12:00:00 +0100

Researchers have discovered a potential new function for anti-epileptic drugs in treating neurodegenerative disorders such as Alzheimer's and Parkinson's disease. The study found that neurons in the brain were protected after treatment with T-type calcium-channel blockers, which are commonly used to treat epilepsy. (Source: ScienceDaily Headlines)

Alzheimer's Society Comment On The Use Of Epilepsy Drugs To Treat Alzheimer's

Health News from Medical News Today — Thu, 29 Oct 2009 08:00:00 +0100

Epilepsy drugs could be developed as a treatment for neurodegenerative diseases according to research published in the journal Molecular Neurodegeneration. The study found that nerve cells lived longer when treated with T-type calcium-channel blockers, which are commonly used to treat epilepsy. (Source: Health News from Medical News Today)

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Alzheimer's And Parkinson's Could Be Treated By Epilepsy Drugs

Health News from Medical News Today — Thu, 29 Oct 2009 07:00:00 +0100

Researchers in the USA have discovered a potential new function for anti-epileptic drugs in treating neurodegenerative disorders such as Alzheimer's and Parkinson's disease. (Source: Health News from Medical News Today)

Epilepsy Drugs May Treat Alzheimer's

WebMD Health — Thu, 29 Oct 2009 05:00:00 +0100

A group of drugs used to treat epilepsy may also treat Alzheimer's and Parkinson's disease, a study shows. (Source: WebMD Health)

The microtubule interacting drug candidate NAP protects against kainic acid toxicity in a rat model of epilepsy

Journal of Neurochemistry — Thu, 29 Oct 2009 00:00:00 +0100

NAP (NAPVSIPQ, generic name, davunetide), a neuroprotective peptide in clinical development for neuroprotection against Alzheimer's disease and other neurodegenerative indications, has been recently shown to provide protection against kainic acid excitotoxicity in hippocampal neuronal cultures. In vivo, kainic acid toxicity models status epilepticus that is associated with hippocampal cell death. Kainic acid toxicity has been previously suggested to involve the microtubule cytoskeleton and NAP is a microtubule-interacting drug candidate. In the current study, kainic acid-treated rats showed epileptic seizures and neuronal death. Injection of NAP into the dentate gyrus partially protected against kainic acid-induced CA3 neuron death. Microarray analysis (composed of > 31 000 probe sets, ana...

Carisbamate as adjunctive treatment of partial onset seizures in adults in two randomized, placebo-controlled trials

Epilepsia — Thu, 29 Oct 2009 00:00:00 +0100

Conclusions: Carisbamate 400 mg/day was effective in patients with refractory partial-onset seizures in one of these global studies. More than 200 mg/day of carisbamate is required for efficacy. Carisbamate was well-tolerated in both studies. (Source: Epilepsia)

Psychosocial impairments in children with epilepsy depend on the side of the focus.

Epilepsy and Behaviour — Thu, 29 Oct 2009 00:00:00 +0100

This article explores the idea that epileptic activity may interfere with psychosocial functions and development in children. In an adult population with epilepsy, left hemispheric seizure focus predicts worse psychosocial functioning. The developmental aspects of these disturbances require further studies. We studied self-report measures of cognitive (locus of control) and emotional (Beck Youth Inventories of Emotional and Social Impairment) functions in 30 children with partial epilepsy (6-15years) and 60 healthy matched controls. Multivariate statistics revealed significant lateralization effects, with left-sided foci (n=15) leading to more external locus of control. Opposite to adults, the children with right hemispheric foci (n=15) exhibited more emotional impairments (anger, disrupti...

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Preoperative depressive symptoms predict postoperative seizure outcome in temporal and frontal lobe epilepsy.

Epilepsy and Behaviour — Thu, 29 Oct 2009 00:00:00 +0100

CONCLUSION: The present results provide evidence for a statistical bidirectionality of the relationship between depressive symptoms and postoperative seizure status in a mixed sample of patients with TLE and FLE. Possible reasons for this bidirectional association include an underlying common pathology in both depression and epilepsy, for example, structural changes or functional alterations in neurotransmitter systems. PMID: 19879810 [PubMed - as supplied by publisher] (Source: Epilepsy and Behaviour)

Epilepsy Drugs could Treat Alzheimer's and Parkinson's

Disabled World — Wed, 28 Oct 2009 15:47:18 +0100

Researchers in the USA have discovered a potential new function for anti-epileptic drugs in treating neurodegenerative disorders such as Alzheimer's and Parkinson's disease. (Source: Disabled World)

Alzheimer's Society comment on the use of epilepsy drugs to treat Alzheimer's

Alzheimers Society — Wed, 28 Oct 2009 14:20:35 +0100

Epilepsy drugs could be developed as a treatment for neurodegenerative diseases according to research published in the journal Molecular Neurodegeneration. (Source: Alzheimers Society)

Neuroprotective effects of blockers for T-type calcium channels

Molecular Neurodegeneration — Wed, 28 Oct 2009 00:00:00 +0100

In this study, we found that neurons showed an increase in viability after treatment with either L-type or T-type calcium channel antagonists. The family of low-voltage activated, or T-type calcium channels, comprise of three members (Cav3.1, Cav3.2, and Cav3.3) based on their respective main pore-forming alpha subunits: alpha 1G, alpha 1H, and alpha 1I. Among these three subunits, alpha 1H is highly expressed in hippocampus and certain cortical regions. However, T-type calcium channel blockers can protect neurons derived from alpha 1H-/- mice, suggesting that neuroprotection demonstrated by these drugs is not through the alpha 1H subunit. In addition, blockers for T-type calcium channels were not able to confer any protection to neurons in long-term cultures, while blockers of L-type calc...

Neuroprotective action of FK-506 (tacrolimus) after seizures induced with pilocarpine: quantitative and topographic elemental analysis of brain tissue.

Journal of Biological Inorganic Chemistry : JBIC — Wed, 28 Oct 2009 00:00:00 +0100

Authors: Chwiej J, Janeczko K, Marciszko M, Czyzycki M, Rickers K, Setkowicz Z In the present work, X-ray fluorescence microscopy with a synchrotron source for the exciting radiation was applied for topographic and quantitative elemental analysis of rat brain tissue in pilocarpine-induced epilepsy and neuroprotection with FK-506. The mass per unit area of the elements P, S, Cl, K, Ca, Fe, Cu, Zn, Se, Br, and Rb was determined in four fields of the hippocampal formation (sectors 1 and 3 of Ammon's horn-CA1, CA3; dentate gyrus; hilus of dentate gyrus) and the parietal cortex. The results obtained for epileptic rats treated with FK-506 (SNF) were compared with data obtained previously for epileptic rats (SNS) and a control group. Many statistically significant differences in elemental com...

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Cognitive deficits in children with benign rolandic epilepsy of childhood or rolandic discharges: A study of children between 4 and 7 years of age with and without seizures compared with healthy controls.

Epilepsy and Behaviour — Wed, 28 Oct 2009 00:00:00 +0100

Authors: Danielsson J, Petermann F Recent developments in research on cognitive abilities in benign rolandic epilepsy of childhood with centrotemporal spikes have led to interest in the following domains: language, memory, executive, motor, and visual-constructive functions. As previous studies have investigated the cognitive development of mainly school-aged children, this study focuses on preschool and elementary school children. Twenty-five children affected by benign rolandic epilepsy/rolandic discharges and 25 healthy children matched for age and sex were enrolled in this retrospective study. The mean IQ scores were 94.76 for children with epilepsy and 99.3 for control children. For the children with benign rolandic epilepsy, cognitive testing revealed increased verbal and nonverb...

No, we should not treat the EEG because most EEGs read as epileptiform are really normal.

Epilepsy and Behaviour — Wed, 28 Oct 2009 00:00:00 +0100

Authors: Benbadis SR PMID: 19879196 [PubMed - as supplied by publisher] (Source: Epilepsy and Behaviour)

Look who is weaving the neural web: glial control of synapse formation.

Current Opinion in Neurobiology — Wed, 28 Oct 2009 00:00:00 +0100

Authors: Bolton MM, Eroglu C Historically, our understanding of synapse formation has been shaped by studies focusing on neurons. However, with advancements in live imaging techniques and molecular and genetic tools we are rapidly uncovering new roles for glia in synapse formation and function. Contact-mediated signals from glia instruct dendrites to become receptive to synaptic partners. Glia-secreted factors coordinate the assembly and apposition of pre-synaptic and post-synaptic specializations. Glial cells also provide cues that are required for synaptic maturation and remodeling of spines both during development and in the adult. As we continue to learn about glial contributions to synapse formation and maintenance, it is likely that glia-derived signals will emerge as potential t...

Transition from cortical slow oscillations of sleep to spike-wave seizures.

Clinical Neurophysiology — Wed, 28 Oct 2009 00:00:00 +0100

CONCLUSIONS: The initial discharges of each seizure engaged both the left frontal pole, which was the primary neural source of this patient's CSOs, and the left temporal lobe, which seemed critical for the evolution of this patient's seizures. SIGNIFICANCE: The correlation of SW seizures with CSOs in animal studies may be observed in humans as well, providing clues to the pathology of arousal regulation in some cases of nocturnal epilepsy. PMID: 19879188 [PubMed - as supplied by publisher] (Source: Clinical Neurophysiology)

Interictal magnetoencephalography and the irritative zone in the electrocorticogram

Brain — Tue, 27 Oct 2009 17:42:26 +0100

Magnetoencephalography (MEG) is considered a useful tool for planning electrode placement for chronic intracranial subdural electrocorticography (ECoG) in candidates for epilepsy surgery or even as a substitute for ECoG. MEG recordings are usually interictal and therefore, at best, reflect the interictal ECoG. To estimate the clinical value of MEG, it is important to know how well interictal MEG reflects interictal activity in the ECoG. From 1998 to 2008, 38 candidates for ECoG underwent a 151-channel MEG recording and 3D magnetic resonance imaging as a part of their presurgical evaluation. Interictal MEG spikes were identified, clustered, averaged and modelled using the multiple signal classification algorithm and co-registered to magnetic resonance imaging. ECoG was continuously recorded...

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Local and remote epileptogenicity in focal cortical dysplasias and neurodevelopmental tumours

Brain — Tue, 27 Oct 2009 17:42:26 +0100

In this study, we have quantified the epileptogenic characteristic of brain structures explored by depth electrodes in 36 patients investigated by stereoelectroencephalography and suffering from focal drug-resistant epilepsy associated with focal cortical dysplasias or dysembryoplastic neuroepithelial tumours. This quantification was performed using the ‘Epileptogenicity Index’ method that accounts for both the propensity of a brain area to generate rapid discharges and the time for this area to get involved in the seizure. Epileptogenicity Index values range from 0 (no epileptogenicity) to 1 (maximal epileptogenicity). We determined Epileptogenicity Index from signals recorded in distinct brain structures including the lesional site. We studied the type of epileptogenic zone o...

The epileptic human hippocampal cornu ammonis 2 region generates spontaneous interictal-like activity in vitro

Brain — Tue, 27 Oct 2009 17:42:25 +0100

In this study, we asked whether a similar population activity is generated in the cornu ammonis 2 region and examined the electrophysiological and neuroanatomical characteristics of human epileptic cornu ammonis 2 neurons that may be involved. Hippocampal slices were prepared from postoperative temporal lobe tissue derived from epileptic patients. Field potentials and multi-unit activity were recorded in vitro using multiple extracellular microelectrodes. Pyramidal cells were characterized in intra-cellular records and were filled with biocytin for subsequent anatomy. Fluorescent immunostaining was made on fixed tissue against the chloride–cation cotransporters sodium-potasium-chloride cotransporter-1 and potassium-chloride cotransporter-2. Light and electron microscopy were used to ...

Spatial characterization of interictal high frequency oscillations in epileptic neocortex

Brain — Tue, 27 Oct 2009 17:42:25 +0100

Interictal high frequency oscillations (HFOs), in particular those with frequency components in excess of 200 Hz, have been proposed as important biomarkers of epileptic cortex as well as the genesis of seizures. We investigated the spatial extent, classification and distribution of HFOs using a dense 4 x 4 mm2 two dimensional microelectrode array implanted in the neocortex of four patients undergoing epilepsy surgery. The majority (97%) of oscillations detected included fast ripples and were concentrated in relatively few recording sites. While most HFOs were limited to single channels, ~10% occurred on a larger spatial scale with simultaneous but morphologically distinct detections in multiple channels. Eighty per cent of these large-scale events were associated with interictal epileptif...

Neonatal seizures and Long QT Syndrome: A cardiocerebral channelopathy?

Epilepsia — Tue, 27 Oct 2009 00:00:00 +0100

We identified a patient with electrophysiologically verified neonatal long QT syndrome (LQTS) and neonatal seizures in the presence of a controlled cardiac rhythm. To find a cause for this unusual combination of phenotypes, we tested the patient for mutations in seven ion channel genes associated with either LQTS or benign familial neonatal seizures (BFNS). Comparative genome hybridization (CGH) was done to exclude the possibility of a contiguous gene syndrome. No mutations were found in the genes (KCNQ2, KCNQ3) associated with BFNS, and CGH was negative. A previously described mutation and a known rare variant were found in the LQTS-associated genes SCN5A and KCNE2. Both are expressed in the brain, and although mutations have not been associated with epilepsy, we propose a pathophysiologi...

Antiepileptic drugs combined with high-frequency electrical stimulation in the ventral hippocampus modify pilocarpine-induced status epilepticus in rats

Epilepsia — Tue, 27 Oct 2009 00:00:00 +0100

Discussion: Subeffective doses of antiepileptic drugs that increase the [gamma]-aminobutyric acid (GABA)ergic neurotransmission may represent a therapeutic tool to augment the HFS-induced anticonvulsant effects. (Source: Epilepsia)

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Seasonality as a risk factor for sudden unexpected death in epilepsy: A study in a large cohort

Epilepsia — Tue, 27 Oct 2009 00:00:00 +0100

Discussion: Some causes of death appear to be related to temperature, but we found no convincing evidence to support a link between temperatures or seasons and sudden unexpected death in epilepsy. It is important to identify risk factors for SUDEP, but it is also important that evidence is established before hypotheses are accepted. (Source: Epilepsia)

Lamotrigine kinetics within the menstrual cycle, after menopause, and with oral contraceptives

Neurology — Mon, 26 Oct 2009 20:01:27 +0100

Conclusions: We observed a higher mean lamotrigine (LTG) clearance in postmenopausal women compared with young women not using oral contraceptives (OCs) and confirmed that OC use may have a strong effect on LTG clearance. There was no significant fluctuation of LTG clearance during the menstrual cycle. (Source: Neurology)

Development of mesial temporal lobe epilepsy in chorea-acanthocytosis

Neurology — Mon, 26 Oct 2009 20:01:27 +0100

(Source: Neurology)

The expression of astroglial glutamate transporters in patients with focal cortical dysplasia: an immunohistochemical study

Acta Neurochirurgica — Mon, 26 Oct 2009 18:08:02 +0100

Conclusion The results of this study suggest a relationship between the decreased glutamate transporter expressions in dysplastic tissues which,in turn, may cause increased extracellular concentrations of glutamate and FCD pathophysiology.Further studies with larger patient populations,investigating the expression of glutamate transporters at mRNA and protein levels, are required to clarify their roles in the pathophysiology of FCD. Content Type Journal ArticleCategory Clinico Pathological StudiesDOI 10.1007/s00701-009-0548-2Authors Mustafa Onur Ulu, Istanbul University Department of Neurosurgery, Cerrahpasa Medical Faculty Istanbul TurkeyTaner Tanriverdi, McGill University Department of Neurosurgery, Montreal Neurological Institute Montreal QC CanadaBuge Oz, Istanbu...

The relevance of interictal rCBF brain SPECT in temporal lobe epilepsy: Diagnostical value and effects of spatial resolution

Annals of Nuclear Medicine — Mon, 26 Oct 2009 17:52:35 +0100

In conclusion, the interictal rCBF-SPECT revealed reasonable sensitivity and PPV in pt. suffering from focal temporal lobe epilepsy and modern SPECT systems showed significantly improved results. Since there is a variety of possible reasons for regional cortical hypoperfusion, the interictal SPECT could add significant information prior to the application of ECoG. This specially appeared to be useful in patients with a normal MRI scan. Furthermore, in patients presenting with a clear pathology on MRI and a corresponding EEG focus, ECoG could be avoided if the interictal rCBF-SPECT additionally showed localized and singular involvement of the affected temporal lobe. ECoG was mainly applied in those patients with relatively wide-spread hypoperfusion additionally involving frontal or pa...

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Why funding epilepsy research matters

Thrive, Children's Hospital Boston — Mon, 26 Oct 2009 14:04:29 +0100

Last night, Frances Jensen, MD, senior associate in Neurology, was featured in a piece on 60 Minutes about the prevalence of epilepsy and the importance of funding research into its cure. Watch the piece here, then keep reading below as Jensen describes how epilepsy is often overlooked as a public health problem and how researchers like her are trying to stop it in its tracks. Also watch below as Jensen shows Katie Couric what an epilepsy looks like from a molecular perspective. Watch CBS News Videos Online By Frances Jensen, MD Last night, research by myself and my team was featured on 60 Minutes in a wonderful story about the impact that epilepsy has on the people with it and the challenges of getting the public – including the agencies that fund research – to pay the disease the at...

Frances Jensen on 60 Minutes: Why funding epilepsy research is important

Thrive, Children's Hospital Boston — Mon, 26 Oct 2009 14:04:29 +0100

Teaching paediatric epilepsy to medical students: A randomised crossover trial

Journal of Paediatrics and Child Health — Mon, 26 Oct 2009 00:00:00 +0100

Conclusion: This is the first randomised crossover trial evaluating the teaching of clinical reasoning in comparative medical education research. Interactive lecturing and computerised tutorial were both effective in teaching observational skills and clinical reasoning. Interactive lecture is the preferred method, and may influence initial engagement in learning. (Source: Journal of Paediatrics and Child Health)

REGIONAL BRAIN PERFUSION IN EPILEPTIC DOGS EVALUATED BY TECHNETIUM-99m-ETHYL CYSTEINATE DIMER SPECT

Veterinary Radiology & Ultrasound — Mon, 26 Oct 2009 00:00:00 +0100

We evaluated the feasibility of interictal single photon emission computed tomography (SPECT) to detect alterations in regional cerebral blood flow and neuronal activity in dogs with idiopathic epilepsy. Twelve dogs with idiopathic epilepsy underwent interictal technetium-99m-ethyl cysteinate dimer SPECT of the brain. Different cortical regions of interest (ROIs), 1 ROI at the cerebellum and 1 ROI at the subcortical area were evaluated by semiquantitative analysis and compared with a control group (18 dogs). Significant hypoperfusion (P=0.02) was present in the subcortical area of epileptic dogs. This hypoperfusion was not associated with seizure frequency, age at onset of seizures, duration of epilepsy, or time since the last seizure. Interictal SPECT did not reveal cortical or cerebellar...

Seizure relapse common in epileptic patients after long-term remission?

NeLM - News — Mon, 26 Oct 2009 00:00:00 +0100

In this study they prospectively followed 256 consecutive patients (aged 12 years and above) from a single centre who received new treatment with AEDs and entered long-term (>1 year) seizure remission. All were followed for a minimum of 2 years (range 2-8.5 years). Treatment was chosen according to the clinical judgment of the treating specialists; in general the first two ... (Source: NeLM - News)

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Enhancing antiepileptic drug adherence: A randomized controlled trial.

Epilepsy and Behaviour — Mon, 26 Oct 2009 00:00:00 +0100

Authors: Brown I, Sheeran P, Reuber M Suboptimal adherence to antiepileptic drug (AED) treatment is commonplace, and increases the risk of status epilepticus and sudden unexplained death in epilepsy. This randomized controlled trial was designed to demonstrate whether an implementation intention intervention involving the completion of a simple self-administered questionnaire linking the intention of taking medication with a particular time, place, and other activity can improve AED treatment schedule adherence. Of the 81 patients with epilepsy who were randomized, 69 completed a 1-month monitoring period with an objective measure of tablet taking (electronic registration of pill bottle openings, Medication Event Monitoring System [MEMS]). Intervention participants showed improved adhe...

Tubulin-related cortical dysgeneses: microtubule dysfunction underlying neuronal migration defects.

Trends in Genetics : TIG — Mon, 26 Oct 2009 00:00:00 +0100

Authors: Jaglin XH, Chelly J The fine tuning of proliferation and neurogenesis, neuronal migration and differentiation and connectivity underlies the proper development of the cerebral cortex. Mutations in genes involved in these processes are responsible for neurodevelopmental disorders, such as cortical dysgeneses, which are usually associated with severe mental retardation and epilepsy. Over the past few years, the importance of cytoskeleton components in cellular processes crucial for cortical development has emerged from a body of functional data. This was reinforced by the association of mutations in the LIS1 and DCX genes, which both encode proteins involved in microtubule (MT) homeostasis, with cerebral cortex developmental disorders. The recent discovery of patients with lisse...

Generic substitution of antiepileptic medications in patients with epilepsy: Is this a potential problem?

American Journal of Health-System Pharmacy : AJHP — Sun, 25 Oct 2009 23:48:37 +0100

Authors: Gauthier-Lewis M, Riley TT PMID: 19850781 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

Does God Have a Place in Psychiatric Treatment Plans?

Psychology Today Anxiety Center — Sun, 25 Oct 2009 21:54:14 +0100

In 1992, my father drove (more like sped) me to the emergency of Lion's Gate Hospital. I was floridly psychotic. I ran from one end of the parkade to the other, shouting ‘I am one with God'. Neither of us knew what was happening. My dad describes it as one of the most terrifying experiences of his life, for me one of the most devastating yet liberating. My diagnosis: rapid-cycling, mixed stated bipolar disorder with mild temporal lobe epilepsy and generalized anxiety disorder. Yeah, say that five times fast! Over the next five years I had four further psychotic episodes, innumerable manias and suicidal depressions and five visits to the psych ward. I feel lucky, for the most part I had incredible health care providers - from the psychiatrist I saw weekly, to the nurses and orderlies who ...

Could Drugs For Mood Disorders, Pain And Epilepsy Cause Psychiatric Disorders Later In Life?

ScienceDaily Headlines — Sun, 25 Oct 2009 15:33:36 +0100

Young animals treated with commonly-prescribed drugs develop behavioral abnormalities in adulthood say researchers. The drugs tested include those used to treat epilepsy, mood disorders and pain. (Source: ScienceDaily Headlines)

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Watch 60 Minutes tonight

Thrive, Children's Hospital Boston — Sun, 25 Oct 2009 13:00:00 +0100

Don’t forget to watch 60 Minutes tonight, featuring the epilepsy research of Children’s Frances Jensen, MD. You can watch a preview here. If you use Twitter, please help us promote the episode by tweeting “http://bit.ly/1t2wdK – tune in to 60 Minutes to see Children’s Hospital docs talk about epilepsy.” Related posts:60 Minutes will feature Children’s epilepsy researchWatch NOVA special tonight featuring Children’s autism researchCatching the lightning (Source: Thrive, Children's Hospital Boston)

Clocks going back could help epilepsy patients, says expert

Nursing Times Breaking News — Sun, 25 Oct 2009 07:00:00 +0100

The extra hour of morning light gained as the clocks go back today could make all the difference to patients with epilepsy. (Source: Nursing Times Breaking News)

Treatment For Epilepsy Is Possible Culprit For Development Of Schizophrenia

ScienceDaily Headlines — Sat, 24 Oct 2009 14:27:03 +0100

Researchers say antiepilectic drug treatments administered when the brain is developing appear to trigger schizophrenia-like behavior in animal models. In humans, having a history of seizures in infancy is a significant risk factor for development of schizophrenia later in life, but it is not known whether the elevated risk is due to seizures themselves, or from side effects antiepileptic drug treatment. (Source: ScienceDaily Headlines)

Visual Field Loss in Patients with Refractory Partial Epilepsy Treated with Vigabatrin: Final Results from an Open-Label, Observational, Multicentre Study

CNS Drugs — Sat, 24 Oct 2009 13:27:50 +0100

(Source: CNS Drugs)

Sudden Unexpected Death in Epilepsy (SUDEP): Update and Reflections

Neurologic Clinics — Sat, 24 Oct 2009 13:25:57 +0100

This article addresses aspects of sudden unexpected death in epilepsy, reflecting on current knowledge and questions that need answers to quantify, monitor, and reduce risk. A brief overview is followed by a discussion of definitions, drug treatment, genetic susceptibility, mechanisms in relation to seizure monitoring units and supervision, with some suggestions for the way forward. (Source: Neurologic Clinics)

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Determinants of Quality of Life in People with Epilepsy

Neurologic Clinics — Sat, 24 Oct 2009 13:25:56 +0100

This article reviews evidence of quality of life (QOL) determinants in people affected by epilepsy, including detractors and promoters. Emerging factors of particular significance for QOL are highlighted, including seizure frequency, medication side effects, psychological comorbidity, and stigma and discrimination. This article also examines the role of resilience, interpreted in its widest sense, for promoting good QOL, even in the presence of poorly controlled seizures. The importance of addressing both clinical and wider psychosocial issues is highlighted and some possible directions for future research into QOL in epilepsy are suggested. (Source: Neurologic Clinics)

Depression and Epilepsy: A Review of Multiple Facets of Their Close Relation

Neurologic Clinics — Sat, 24 Oct 2009 13:25:56 +0100

This article reviews these data, the clinical manifestations of depressive disorders in PWE, and their significant impact on the suicidal risk and quality of life. (Source: Neurologic Clinics)

The Emerging Architecture of Neuropsychological Impairment in Epilepsy

Neurologic Clinics — Sat, 24 Oct 2009 13:25:56 +0100

A new literature is now under way, one linking cognitive abnormalities directly to indices of structural, functional, metabolic, and other neurobiologic markers of cerebral integrity, independent of their association with clinical epilepsy characteristics. These trends are reviewed in this article. The focus is on temporal lobe epilepsy (TLE) as a model with which to address the core points because this form of localization-related epilepsy has been very carefully studied from both a cognitive and imaging standpoint. Some pertinent historical issues are touched on first, followed by more detailed reviews of the cognitive and neuroimaging abnormalities that have been found in TLE, followed by an overview of studies examining direct structure-function relationships in TLE and other epilepsie...

The Etiology of Psychogenic Non-Epileptic Seizures: Toward a Biopsychosocial Model

Neurologic Clinics — Sat, 24 Oct 2009 13:25:56 +0100

This article summarizes current knowledge about the etiology of PNES. Through describing the interactions of predisposing, precipitating, perpetuating, and triggering factors, an integrated biopsychosocial model of a complex disorder is developed. PNES emerge as a dissociative response to a range of different stressors in vulnerable individuals. Once established, maintaining factors turn a temporary disturbance into a chronically disabling disorder. (Source: Neurologic Clinics)

Predicting Seizures: A Behavioral Approach

Neurologic Clinics — Sat, 24 Oct 2009 13:25:56 +0100

This article reviews the clinical evidence for seizure prediction. The epilepsy cycle is considered, including the interictal, preictal, ictal, and postictal phases. Evidence suggesting that the preictal phase can sometimes be identified based on neurophysiologic signals, premonitory features, the presence of trigger factors, or self-report is discussed. Diary studies have shown that seizures are not randomly distributed in time and that a subgroup of persons with epilepsy can predict an impending seizure. Paper diary data and preliminary analysis of electronic diary data suggest that seizure prediction is feasible. (Source: Neurologic Clinics)

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Hormonal Aspects of Epilepsy

Neurologic Clinics — Sat, 24 Oct 2009 13:25:56 +0100

The interactions between hormones, epilepsy, and the medications used to treat epilepsy are complex, with tri-directional interactions which affect both men and women in various ways. Abnormalities of baseline endocrine status occur more commonly in people with epilepsy, and are most often described for the sex steroid hormone axis. Common symptoms include sexual dysfunction, decreased fertility, premature menopause, and polycystic ovarian syndrome. Antiepileptic drugs (AEDs) and hormones have a bidirectional interaction, with a decrease in the efficacy of hormonal contraceptive agents with some AEDs and a decrease in the concentration and efficacy of other AEDs with hormonal contraceptives. Endogenous hormones can influence seizure severity and frequency, resulting in catamenial patterns ...

Selection of Antiepileptic Drugs in Adults

Neurologic Clinics — Sat, 24 Oct 2009 13:25:56 +0100

This article explores the rationale for treatment selection in adults with epilepsy. (Source: Neurologic Clinics)

Teratogenic Effects of Antiepileptic Medications

Neurologic Clinics — Sat, 24 Oct 2009 13:25:56 +0100

During the last few years epilepsy and pregnancy registries and other large scale observational studies have provided new information on the teratogenic effects of the most frequently used antiepileptic drugs (AEDs). The prevalence of major congenital malformations associated with exposure to carbamazepine or lamotrigine appears to be only marginally increased from the expected, while malformation rates with valproate have been reported to be 2 to 4 times higher. Recent studies also suggest that compared with carbamazepine, lamotrigine and phenytoin, exposure to valproate in utero may be associated with poorer postnatal cognitive development. However, adverse outcomes with valproate appear to be dose-related, and doses below 800-1,000 mg/day might not be associated with worse outcome than ...

Identification of Pharmacoresistant Epilepsy

Neurologic Clinics — Sat, 24 Oct 2009 13:25:56 +0100

There is no single definition of pharmacoresistant (intractable, refractory) epilepsy. Prospective identification of pharmacoresistance is complicated by the variability of its appearance across different types of epilepsy and the variability of seizure control within a given patient over time. Failure of informative trials of two appropriate antiepileptic drugs has been recommended as a threshold that should trigger referral for evaluation at a comprehensive epilepsy center. Maximizing seizure control is imperative for reducing the risks and consequences of epilepsy, including the cognitive and psychiatric comorbidities and even sudden death. (Source: Neurologic Clinics)

Localization in Epilepsy

Neurologic Clinics — Sat, 24 Oct 2009 13:25:56 +0100

Pharmacologic therapy represents the first line of treatment of epilepsy and is effective in most patients. However, about 20% to 30% of cases develop intractable seizures that cannot be controlled by medication alone. In such cases, surgical intervention is considered for therapeutic, often curative purposes. Dynamic spatiotemporal variability in the epileptic focus renders seizure localization a challenge to the clinician. Many diagnostic modalities have been developed to identify different aspects of the epileptic focus. Older techniques are being increasingly supplemented by a variety of anatomic and functional imaging modalities that can help clarify discrepancies. Invasive electroencephalography remains the gold standard for identifying epileptic foci and guiding the surgeon to succe...

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Therapeutic Brain Stimulation for Epilepsy

Neurologic Clinics — Sat, 24 Oct 2009 13:25:56 +0100

This article concentrates on clinical studies of DBS for epilepsy. (Source: Neurologic Clinics)

Preface

Neurologic Clinics — Sat, 24 Oct 2009 13:25:55 +0100

The diagnosis and management of patients who have epilepsy have greatly evolved over recent years. This issue of Neurologic Clinics presents state-of-the-art reviews by renowned experts of critical issues that illustrate this evolution and underscore their importance in the care of patients. The first six papers focus on the interrelationships between seizures and psychological, neuropsychological, and hormonal factors. The next five papers discuss pharmacologic treatment selection, drug resistance, approaches to localizing seizure onset, and deep brain stimulation as a possible non-pharmacological intervention. The final two papers present an update on the genetics of idiopathic epilepsies and a thought-provoking approach to sudden, unexpected death in epilepsy. (Source: Neurologic Clinic...

60 Minutes will feature Children’s epilepsy research

Thrive, Children's Hospital Boston — Sat, 24 Oct 2009 13:00:29 +0100

Did you know that epilepsy affects over 3 million people in the United States? Despite the fact that it affects more people than Parkinson’s, cerebral palsy and multiple sclerosis combined, the disease and its causes remain stubbornly bewildering. Tomorrow, the news program 60 Minutes will feature the epilepsy research of Children’s Frances Jensen, MD. You can watch a preview here. If you use Twitter, please help us promote the episode by tweeting “http://bit.ly/1t2wdK – tune in to 60 Minutes this Sunday to see Children’s Hospital docs talk about epilepsy.” Read about how one young girl fought epilepsy and won. Related posts:140 characters about 140 yearsCatching the lightningHealth headlines: August 14 (Source: Thrive, Children's Hospital Boston...

Video: Preview: Fighting for a Cure

Health News: CBSNews.com — Fri, 23 Oct 2009 22:28:13 +0100

More Americans are suffering from epilepsy than Parkinson's, cerebral palsy and multiple sclerosis combined. Katie Couric reports on a disease that may not be getting the attention it deserves. (Source: Health News: CBSNews.com)

Prevalence of auditory sequelae after pyogenic meningitis in children

Revista da Sociedade Brasileira de Fonoaudiologia — Fri, 23 Oct 2009 15:40:00 +0100

CONCLUSION: The results indicate the need for audiological monitoring and neurological follow-up in children with previous history of pyogenic meningitis, especially those infected in early ages, seeking to identify possible hearing impairments and to intervene as soon as possible, through specialized intervention, prothetization, and oral language rehabilitation. (Source: Revista da Sociedade Brasileira de Fonoaudiologia)

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Childhood Meds Lead to Behavior Disorders?

Medical Headlines From Ivanhoe.com — Fri, 23 Oct 2009 05:00:00 +0100

Young animals treated with commonly prescribed drugs to treat epilepsy, mood disorders and pain develop behavioral abnormalities in adulthood, according to researchers at Georgetown University Medical Center (GUMC). (Source: Medical Headlines From Ivanhoe.com)

Deletion of 15q11.2–15q13.1 in isolated human hemimegalencephaly

Acta Neuropathologica — Thu, 22 Oct 2009 18:56:04 +0100

Content Type Journal ArticleCategory CorrespondenceDOI 10.1007/s00401-009-0603-3Authors Marianna Baybis, University of Pennsylvania Medical Center Department of Neurology, PENN Epilepsy Center 3 West Gates Bldg., 3400 Spruce St. Philadelphia PA 19104 USAEleonora Aronica, University of Amsterdam Department of (Neuro)Pathology, Academic Medical Center Amsterdam The NetherlandsKatherine L. Nathanson, University of Pennsylvania Medical Center Division of Medical Genetics Philadelphia PA USAPeter B. Crino, University of Pennsylvania Medical Center Department of Neurology, PENN Epilepsy Center 3 West Gates Bldg., 3400 Spruce St. Philadelphia PA 19104 USA Journal Acta NeuropathologicaOnline ISSN 1432-0533Print ISSN 0001-6322 (Source: Acta Neuropathologica)

How I Treat Patients with EEG Patterns on the Ictal–Interictal Continuum in the Neuro ICU

Neurocritical Care — Thu, 22 Oct 2009 18:41:18 +0100

Abstract Refractory status epilepticus (RSE) is associated with a high risk of poor outcome and treated by most neurointensivists with continuous intravenous antiepileptic medications (cIV-AEDs). Continuous EEG monitoring has allowed us to unveil a number of epileptiform patterns of less certain significance. These have been labeled ictal to interictal continuum (IIC), many of which are associated with poor outcome. It is unclear to which extent individual patterns are epiphenomena or lead to additional brain injury. The treatment of these patterns is highly controversial and guidelines how to manage them are non existent. In this review of a challenging case, I will discuss a number of approaches to determine the ictal nature of the IIC in an effort to minimize neuronal i...

Which clinical features distinguish inflicted from non-inflicted brain injury? A systematic review

Archives of Disease in Childhood — Thu, 22 Oct 2009 00:11:52 +0100

Conclusions: This systematic review shows that apnoea and retinal haemorrhage have a high odds ratio for association with iBI. This review identifies key features that should be recorded in the assessment of children where iBI is suspected and may help clinicians to define the likelihood of iBI. (Source: Archives of Disease in Childhood)

Opsoclonus myoclonus: a non-epileptic movement disorder that may present as status epilepticus

Archives of Disease in Childhood — Thu, 22 Oct 2009 00:11:52 +0100

We describe two cases of a non-epileptic florid movement disorder presenting as status epilepticus. Both patients presented with florid jerking of the limbs and eyes. Convulsive status epilepticus related to presumed meningitis or encephalitis was suspected in both cases. The patients received treatment for seizures, without resolution of the abnormal movements, resulting ultimately in anaesthetic, intubation and ventilation. EEGs showed no epileptic discharges. The diagnosis was opsoclonus myoclonus syndrome in both. One patient was treated with adrenocorticotropic hormone (40 IU/day), the other with prednisolone (4 mg/kg/day) with rapid resolution of symptoms. Neither patient had an underlying neoplasm or infectious agent identified. To date, neither patient has suffered a relapse of sym...

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QUESTION 1. Efficacy of vagal nerve stimulation in children with medically intractable epilepsy

Archives of Disease in Childhood — Thu, 22 Oct 2009 00:11:52 +0100

(Source: Archives of Disease in Childhood)

The impact of social support on health related quality of life in persons with epilepsy.

Epilepsy and Behaviour — Thu, 22 Oct 2009 00:00:00 +0100

Authors: Charyton C, Elliott JO, Lu B, Moore JL Previous studies have found that psychosocial factors have the greatest impact on health-related quality of life (HRQOL). Social support can buffer the negative impact of stressful events and chronic health conditions. To date, no population studies have examined the association between social support and epilepsy. In the 2003 California Health Interview Survey (CHIS), four questions were used to assess social support. A set of survey weight-adjusted logistic regression analyses were conducted with self-rated health status as the outcome. In those regression models, we examined the effect of epilepsy status, social support, and their interactions, after controlling for demographics. Analyses examining the interaction between epilepsy and ...

Commentary on Bonnier P. L'aschématie. Rev Neurol (Paris) 1905;13:605-9.

Epilepsy and Behaviour — Thu, 22 Oct 2009 00:00:00 +0100

Commentary on Bonnier P. L'aschématie. Rev Neurol (Paris) 1905;13:605-9. Epilepsy Behav. 2009 Oct 22; Authors: Vallar G, Rode G PMID: 19854110 [PubMed - as supplied by publisher] (Source: Epilepsy and Behaviour)

Factors that affect interictal cardiovascular autonomic dysfunction in temporal lobe epilepsy: Role of hippocampal sclerosis.

Epilepsy and Behaviour — Thu, 22 Oct 2009 00:00:00 +0100

This study shows that in addition to factors related to the chronic nature of epilepsy and antiepileptic drug use, hippocampal sclerosis may cause autonomic dysfunction during the interictal period in persons with temporal lobe epilepsy. PMID: 19854109 [PubMed - as supplied by publisher] (Source: Epilepsy and Behaviour)

Correlation between memory, proton magnetic resonance spectroscopy, and interictal epileptiform discharges in temporal lobe epilepsy related to mesial temporal sclerosis.

Epilepsy and Behaviour — Thu, 22 Oct 2009 00:00:00 +0100

CONCLUSIONS: These findings suggest that IEDs and NAA/(Cho+Cr) ratios reflecting neural metabolism are closely related to verbal memory function in mesial temporal sclerosis. Higher interictal activity on the EEG was associated with a decline in total NAA in contralateral mesial temporal structures. PMID: 19854108 [PubMed - as supplied by publisher] (Source: Epilepsy and Behaviour)

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MMPI-2 profiles: Fibromyalgia Patients Compared to Epileptic and Non-Epileptic Seizure Patients.

The Clinical Neuropsychologist — Thu, 22 Oct 2009 00:00:00 +0100

Authors: Johnson AL, Storzbach D, Binder LM, Barkhuizen A, Kent Anger W, Salinsky MC, Tun SM, Rohlman DS We compared MMPI-2 profiles of Gulf War veterans with fibromyalgia (FM) to epileptic seizure (ES) patients, psychogenic non-epileptic seizure (PNES) patients, and Gulf War veteran healthy controls. Both PNES and FM are medically unexplained conditions. In previous MMPI-2 research PNES patients were shown to have significantly higher Hs and Hy clinical scales than ES patients. In the present research the FM group had significantly higher Hs and Hy scale scores than both the ES group and the healthy control group. There was no significant difference between the FM and PNES Hs scale scores; however, the FM Hy scale score was significantly lower than the PNES Hy scale score. Present fin...

Seizures in a 9 month old girl

BMJ Online First — Wed, 21 Oct 2009 23:05:50 +0100

(Source: BMJ Online First)

A case of luteinizing thecoma with sclerosing peritonitis: Revisiting a link with anti-epileptic drugs

Pediatric Blood and Cancer — Wed, 21 Oct 2009 23:00:00 +0100

Luteinizing thecoma with sclerosing peritonitis (LTSP) is a rare ovarian tumor of unclear etiology and pathogenesis. The diagnostic entity was proposed in 1994, but a number of earlier reports described possible cases, and some suggested an association with anti-epileptic drugs (AEDs). In presenting a new case we review the literature of previous cases to evaluate the possibility of such a link. When cases in reproductively immature patients are considered, evidence for an association between LTSP and AEDs is strongly suggested despite the rarity of the condition. Pediatr Blood Cancer © 2009 Wiley-Liss, Inc. (Source: Pediatric Blood and Cancer)

Innate but not adaptive immune responses contribute to behavioral seizures following viral infection

Epilepsia — Wed, 21 Oct 2009 23:00:00 +0100

Discussion: We have implicated the innate immune response to viral infection, specifically TNF-[alpha] and IL-6, and concomitant inflammatory changes in the brain as contributing to the development of acute seizures. This model is a potential infection-driven model of mesial temporal lobe epilepsy with hippocampal sclerosis. (Source: Epilepsia)

Experts study epilepsy drugs risk

Nursing in Practice — Wed, 21 Oct 2009 13:53:19 +0100

Epilepsy drugs given to youngsters may lead to the development of schizophrenia in later life after study on lab animals finds link between the two (Source: Nursing in Practice)

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Schizophrenia link to epilepsy drug

Pharmacy Europe — Wed, 21 Oct 2009 13:11:52 +0100

Exposure to anti-epileptic drug (AED) treatment at key points in brain development increases schizophrenia-like behaviour (Source: Pharmacy Europe)

Epilepsy Treatment Is A Possible Culprit For Development Of Schizophrenia

Health News from Medical News Today — Wed, 21 Oct 2009 13:00:00 +0100

Researchers say antiepilectic drug treatments administered when the brain is developing appear to trigger schizophrenia-like behavior in animal models. (Source: Health News from Medical News Today)

Classifying Epilepsy Diseases Using Artificial Neural Networks and Genetic Algorithm

Journal of Medical Systems — Wed, 21 Oct 2009 12:15:54 +0100

This study shows that the artificial neural network increases the classification performance using genetic algorithm. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s10916-009-9385-3Authors Sabri Koçer, Gazi University, Teknikokullar Department of Electronics and Computer Education, Faculty of Technical Education Ankara TurkeyM. Rahmi Canal, Gazi University, Teknikokullar Department of Electronics and Computer Education, Faculty of Technical Education Ankara Turkey Journal Journal of Medical SystemsOnline ISSN 1573-689XPrint ISSN 0148-5598 (Source: Journal of Medical Systems)

Epilepsy drugs 'risk schizophrenia'

Nursing Times Breaking News — Wed, 21 Oct 2009 11:58:00 +0100

Young people who take drugs to control epilepsy in early life may be at risk of developing schizophrenia when they are older, according to new research. (Source: Nursing Times Breaking News)

European Union criticised for health policies towards developing countries

BMJ Online First — Wed, 21 Oct 2009 10:42:06 +0100

(Source: BMJ Online First)

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Case registers in pregnancy?

BMJ Online First — Wed, 21 Oct 2009 10:42:05 +0100

(Source: BMJ Online First)

Should patients with psychogenic nonepileptic seizures be allowed to drive? Recommendations of German experts.

Epilepsy and Behaviour — Wed, 21 Oct 2009 00:00:00 +0100

Authors: Specht U, Thorbecke R In the absence of evidence-based regulations on the driving ability of patients with psychogenic nonepileptic seizures (PNES), we asked 41 German epileptologists via e-mail for their recommendations on driving with PNES. This survey was modeled on an earlier study by Benbadis et al. [11] in the United States and was compared with it. Thirty-four (82.9%) epileptologists responded. Three responses were possible: (A) same restrictions as stipulated for patients with epilepsy, answered by 11 epileptologists (32.4%); (B) no restrictions at all, which no German expert gave as an answer (0%); (C) decision on an individual basis, answered by 23 experts (67.6%). The divergent approaches reflect the poor data on motor vehicle accidents of patients with PNES and the...

From Galapagos to the labs: Darwinian medicine and epilepsy today.

Epilepsy and Behaviour — Wed, 21 Oct 2009 00:00:00 +0100

Authors: Scorza FA, Cysneiros RM, Terra VC, Arida RM, Scorza CA, Cavalheiro EA In 1991, a mummy frozen in ice was found by climbers in the Tyrolean Alps. Otzi the Iceman has since been studied in the light of evolutionary explanations for diseases. This year, which marks Charles Darwin's 200th birthday and the 150th anniversary of his publication On the Origin of Species, should re-ignite discussion of the importance of the correlation between nutritional diet and diseases. Epilepsy is one of the commonest diseases in the world. Individuals with epilepsy are at higher risk of death than the general population, and sudden unexpected death (SUDEP) is the most important direct epilepsy-related cause of death. A number of factors may influence the risk for SUDEP. Along these lines, several...

Review: Epilepsy in later life

NeLM - News — Tue, 20 Oct 2009 23:00:00 +0100

Source: Lancet Neurology Area: News Lancet Neurology has featured a review on the effective assessment and management of epilepsy in later life. The review discusses causes such as cerebrovascular disease, tumours, neurodegenerative disease, trauma, and also outlines factors affecting the choice of pharmacological management. (Source: NeLM - News)

Effect of acute and chronic treatment with milnacipran potentiates the anticonvulsant activity of conventional antiepileptic drugs in the maximal electroshock-induced seizures in mice

Psychopharmacology — Tue, 20 Oct 2009 16:31:24 +0100

Conclusions Acute, but not chronic, treatment with MLN can increase the effectiveness of some AEDs against MES-induced seizures in mice. It seems that MLN may also be considered as a candidate drug for clinical trials in patients with epilepsy and depressive disorders. Content Type Journal ArticleCategory Original InvestigationDOI 10.1007/s00213-009-1698-xAuthors Kinga K. Borowicz, Lublin Medical University Experimental Neuropathophysiology Unit, Department of Pathophysiology Jaczewskiego 8 Lublin PolandKamila Furmanek-Karwowska, Lublin Medical University Experimental Neuropathophysiology Unit, Department of Pathophysiology Jaczewskiego 8 Lublin PolandMarta Morawska, Lublin Medical University Experimental Neuropathophysiology Unit, Department of Pathophysiology Jaczew...

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Comparative study of five antiepileptic drugs on a translational cognitive measure in the rat: relationship to antiepileptic property

Psychopharmacology — Tue, 20 Oct 2009 16:31:22 +0100

Conclusions These results highlight somewhat similar effects of phenytoin, valproate, pregabalin and lacosamide on attention and reaction time, and comparison to efficacious doses from the seizure tests support the view that there may be a better separation with the newer AEDs. Levetiracetam had no detrimental effect in the 5-CSRTT, which may be consistent with clinical experience where the drug is considered to be well tolerated amongst the AED class. Content Type Journal ArticleCategory Original InvestigationDOI 10.1007/s00213-009-1682-5Authors Guy A. Higgins, NPS Pharmaceuticals 101 College Street Toronto Canada M5G 1L8Nathalie Breysse, NPS Pharmaceuticals 101 College Street Toronto Canada M5G 1L8Elijus Undzys, NPS Pharmaceuticals 101 College Street Toronto Canada...

Excellence in Epilepsy Journalism Award

Pharmacy Europe — Tue, 20 Oct 2009 13:05:37 +0100

IBE and UCB announce winners of award to improve understanding of epilepsy around the world (Source: Pharmacy Europe)

Treatment for epilepsy is a possible culprit for development of schizophrenia

EurekAlert! - Social and Behavioral Science — Tue, 20 Oct 2009 04:00:00 +0100

(Georgetown University Medical Center) Researchers say antiepilectic drug treatments administered when the brain is developing appear to trigger schizophrenia-like behavior in animal models. In humans, having a history of seizures in infancy is a significant risk factor for development of schizophrenia later in life, but it is not known whether the elevated risk is due to seizures themselves, or from side effects antiepileptic drug treatment. (Source: EurekAlert! - Social and Behavioral Science)

Could drugs for mood disorders, pain and epilepsy cause psychiatric disorders later in life?

EurekAlert! - Social and Behavioral Science — Tue, 20 Oct 2009 04:00:00 +0100

(Georgetown University Medical Center) Young animals treated with commonly-prescribed drugs develop behavioral abnormalities in adulthood say researchers at Georgetown University Medical Center. The drugs tested include those used to treat epilepsy, mood disorders and pain. (Source: EurekAlert! - Social and Behavioral Science)

The efficacy of vagal nerve stimulation in children with pharmacoresistant epilepsy: Practical experience at a Turkish tertiary referral center.

European Journal of Paediatric Neurology — Tue, 20 Oct 2009 00:00:00 +0100

CONCLUSIONS: Although it is an expensive method, VNS is an effective treatment method. This series shows the necessity of long-term follow-up series for understanding the efficacy and advantages of VNS. Prospective, long-term double-blind studies with large samples are needed to confirm the present study's findings. PMID: 19850501 [PubMed - as supplied by publisher] (Source: European Journal of Paediatric Neurology)

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Mechanisms involved in the conduction of anterior temporal epileptiform discharges to the scalp.

Clinical Neurophysiology — Tue, 20 Oct 2009 00:00:00 +0100

CONCLUSIONS: The topography of anterior temporal discharges is most readily explained by volume conduction through high conductivity skull foramina. SIGNIFICANCE: The role of skull holes should be incorporated in EEG and possibly in MEG source localisation models and additional facial electrodes can be useful in the evaluation of bitemporal discharges in temporal lobe epilepsy. PMID: 19850514 [PubMed - as supplied by publisher] (Source: Clinical Neurophysiology)

Abnormal expressions of glutamate transporters and metabotropic glutamate receptor 1 in the spontaneously epileptic rat hippocampus.

Brain Research Bulletin — Tue, 20 Oct 2009 00:00:00 +0100

In this study, the glutamate concentration in SERs hippocampus was increased compared with that of control rats by high performance liquid chromatography; The mRNA expressions of GLAST and mGluR1 in SERs hippocampus were significantly lower than those in control rats hippocampus, whereas an abundant increase in mRNA for GLT-1 was observed by RT-PCR; EAAC-1 and mGluR1 protein in SERs and control rats were localized widely in the hippocampus including CA1, CA3 and dentate gyrus regions by immunohistochemistry; The number of GLAST and mGluR1-positive cells in the hippocampus of SERs were less than those in control rats, especially for CA3 and DG region; The protein expression of GLT-1 was up-regulated, but the protein expressions of GLAST and mGluR1 were down-regulated in SER hippocampus by w...

Value of electrical stimulation and high frequency oscillations (80–500 Hz) in identifying epileptogenic areas during intracranial EEG recordings

Epilepsia — Mon, 19 Oct 2009 23:00:00 +0100

This study investigates whether interictal HFOs are more frequent in areas with a low threshold to provoke ADs or seizures.Methods: Intracranial EEG studies were filtered at 500 Hz and sampled at 2,000 Hz. HFOs were visually identified. Twenty patients underwent ES, with gradually increasing currents. Results were interpreted as agreeing or disagreeing with the intracranial study (clinical-EEG seizure onset defined the SOZ). Current thresholds provoking an AD or seizure were correlated with the rate of HFOs of each channel.Results: ES provoked a seizure in 12 and ADs in 19 patients. Sixteen patients showed an ES response inside the SOZ, and 10 had additional areas with ADs. The response was more specific for mesiotemporal than for neocortical channels. HFO rates were negatively correlated ...

The ketogenic diet in treatment of two adults with prolonged nonconvulsive status epilepticus

Epilepsia — Mon, 19 Oct 2009 23:00:00 +0100

We report successful use of the KD in two adult patients with prolonged nonconvulsive SE (NCSE) refractory to multiple other interventions. Our observations suggest induction of ketosis may be a novel strategy to safely and effectively treat status in adults even after weeks to months of refractory seizures. Although there are few data regarding the use of the ketogenic diet in the treatment of adult epilepsy syndromes, it may be an option for the treatment of adults with refractory, prolonged SE. (Source: Epilepsia)

Factors contributing to depression in patients with epilepsy

Epilepsia — Mon, 19 Oct 2009 23:00:00 +0100

We investigated factors contributing to depression in patients with epilepsy. Data were collected from 150 adult patients. Beck Depression Inventory (BDI), Beck Anxiety Inventory, Daily Hassles Scale, Epilepsy Self-Efficacy Scale, Social Support Scale, Stress Coping Style Checklist, and Quality of Life in Epilepsy Inventory 31 (QOLIE-31) were used. The mean BDI score was 13.4 [standard deviation (SD) 9.0]. Abnormal BDI scores were recorded in 93 patients. Six significant predictors of BDI were identified in a stepwise linear regression analysis: level of stress (p < 0.001), social support (p = 0.037), anxiety (p = 0.001), self-efficacy (p < 0.001), employment status (p = 0.021), and age (p = 0.042). Stress accounted for 38.8% of the variance in BDI score, social support accounted for 6.8%,...

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Sequential intrarectal diazepam and intravenous levetiracetam in treating acute repetitive and prolonged seizures

Epilepsia — Mon, 19 Oct 2009 23:00:00 +0100

In this retrospective study of institutionalized patients with mental retardation, we present the efficacy and safety of sequential treatment with intrarectal diazepam (IRD) gel (Diastat) and intravenous levetiracetam (IVL) in comparison with either treatment alone for acute repetitive or prolonged seizures (ARPS). We defined ARPS as [ge]3 seizures of any type within 1 h or a single seizure of any type lasting [ge]3 min. Eighty-eight ARPS episodes were treated in 25 patients (14 female, age 21[ndash]72 years), with mainly symptomatic generalized epilepsy. There were no adverse events directly attributable to the administration of IRD or IVL. Seizure recurrence within 4 h of treatment, the primary outcome measure, was significantly lower after combined sequential IRD + IVL treatment (3 of 3...

A population-based study of risk of epilepsy after hospitalization for traumatic brain injury

Epilepsia — Mon, 19 Oct 2009 23:00:00 +0100

This study was undertaken to determine the risk of developing posttraumatic epilepsy (PTE) within 3 years after discharge among a population-based sample of older adolescents and adults hospitalized with traumatic brain injury (TBI) in South Carolina. It also identifies characteristics related to development of PTE within this population.Methods: A stratified random sample of persons aged 15 and older with TBI was selected from the South Carolina nonfederal hospital discharge dataset for four consecutive years. Medical records of recruits were reviewed, and they participated in up to three yearly follow-up telephone interviews.Results: The cumulative incidence of PTE in the first 3 years after discharge, after adjusting for loss to follow-up, was 4.4 per 100 persons over 3 years for hospit...

Adenosine A1 receptor blockage mediates theophylline-associated seizures

Epilepsia — Mon, 19 Oct 2009 23:00:00 +0100

Theophylline-associated seizures (TAS) often progress to prolonged or treatment-resistant convulsions. Theophylline is a nonselective adenosine receptor antagonist. Adenosine is an endogenous anticonvulsant that can terminate seizures. Fever and young age have been reported to be risk factors for TAS. To elucidate the mechanism of TAS, we investigated the effect of theophylline and adenosine receptor ligands on hyperthermia-induced seizures in juvenile rats. The treatment dose of theophylline or control saline was injected intraperitoneally 1 h before hyperthermia-induced seizures. The seizure threshold in the theophylline group was significantly lower and seizure duration was significantly longer than those in the control group. The addition of a selective adenosine A1 receptor agonist an...

Severe and disabling constipation: An adverse effect of pregabalin

Epilepsia — Mon, 19 Oct 2009 23:00:00 +0100

The incidence of constipation as an adverse effect of pregabalin has previously been reported as low, with all cases described as either mild or moderate. From the experience of a tertiary referral epilepsy hospital center, we report several cases of severe and disabling constipation after initiating pregabalin, and resolving only on drug withdrawal. Of 80 consecutive patients, six (7.5%) developed significant constipation within 1[ndash]2 weeks of commencing pregabalin. Constipation was the most frequent adverse effect that required pregabalin to be withdrawn (6.3% of patients). The severity of symptoms was dose dependent. Pregabalin can cause marked constipation in some patients, and can lead to multiple unnecessary investigations and procedures if the clinician is not aware of this enti...