Nattsumi's Epilepsy Diary

Contributing Authors StatusEpilepticus

Wed, 22 Feb 2012 19:58:18 GMT

Massimo Avoli, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada Roy A. Bakay, Department of Neurological Surgery, Chicago Institute of Neurosurgery and Neuroresearch, Rush Presbyterian-St. Luke's Medical Center, Chicago, IL Scott C. Baraban, Department of Neurological Surgery, University of California San Francisco, San Francisco, CA Tallie Z. Baram, Departments of Pediatrics and Anatomy and Neurobiology, University of California Irvine, Irvine, CA Stefania...

Diagnostic Evaluation DuringSleep

Wed, 22 Feb 2012 19:25:04 GMT

For many patients, the history is sufficient to diagnose an arousal disorder no laboratory studies are required. For example, typical episodes of sleepwalking or sleep terror that occur in children or young adults generally do not require additional evaluation. Diagnostic studies are more often needed if the history has atypical features, such as stereotyped behaviors, frequent occurrence in the second half of the night, or onset during adulthood. Definitive diagnosis with laboratory studies...

Individualized patientdriven QOL assessment techniques PostictalPsychosis

Wed, 22 Feb 2012 18:33:53 GMT

There is a fundamental tension in the measurement of QOL. Since what is deemed important for QOL is acknowledged to be subjective and idiosyncratic, differences being influenced by a variety of personal and cultural factors, an appraisal of QOL should strive to capture the individual's subjectively appraised phenomenological experience. On the other hand, the hallmark of scientific measurement is reliable, 'objective', empirical data collection. Researchers have devised QOL measurement...

Ilae Classification Of Seizure Type EpilepsyTreatment

Wed, 22 Feb 2012 17:58:26 GMT

Epilepsy is a variable condition, and it is therefore appropriate to devise a system of classification. The International League Against Epilepsy ILAE has been engaged on this task for over 40 years, proposing and then revising various systems. The classification most widely accepted is a classification of seizure type i.e. of the phenomenology of seizures rather than of epilepsies . Such a classification could be based on various criteria, for instance the cerebral region in which the seizure...

Inplane Spatial Resolution EpilepsyNeuroimaging

Wed, 22 Feb 2012 08:40:30 GMT

The in-plane spatial resolution is determined by the matrix size and the size of the FOV that is how many voxels we divide the area we are imaging into. A typical matrix in clinical practice is 256 x 256, which means that the whole image is divided, in two dimensions, into an array of this many compartments or picture elements pixels . The actual size of the pixels will depend on the FOV. If we know the third dimension of the slice thickness as well we can determine the voxel volume, i.e. the...

Violence and postictal psychosis PostictalPsychosis

Wed, 22 Feb 2012 03:44:30 GMT

Violent behaviour elicited in the course of postictal psychosis deserves a special comment. The argument against the view that epilepsy is closely related to a libera tion of aggressive impulses has marked modern epileptology, with the result that epi-leptologists have almost succeeded in dismissing this old view. However, in the course of our investigation of postictal psychosis, the sporadic episodes of abrupt violent behaviour that we observed impressed us greatly. In a previous study...

SPECT single photon emission computerized tomography scanning DuringPregnancy

Wed, 22 Feb 2012 01:39:26 GMT

An investigation of the blood flow in the brain. Spike. A particular wave pattern in EEG that is typical of epilepsy. Spina bifida. Malformation of the spinal cord and spine. Spinal cord. An enlarged collection of nerve fibers and nerve cell bodies that exits the skull and travels through the vertebrae of the spine. Spinal fluid. Fluid that surrounds the brain and the spinal cord. Status epilepticus. A seizure that lasts longer than 30 minutes, or a series of seizures with no recovery of...

Dedication Lobe Epilepsy 2

Tue, 21 Feb 2012 21:04:55 GMT

This book, ''Temporal Lobe Epilepsy and the Mind-Brain Relationship A New Perspective,'' is dedicated to the memory of Mark RayportM.D. C.M., Ph.D., F.A.C.S., who died on March 4, 2003. The chapters of this book comprise some of the unpublished manuscripts written with his wife and collaborator, neuropsychiatrist, Shirley M. Ferguson, M.D., during his lifetime, and some written after Dr. Rayport's death. The findings reflect Dr. Rayport's compelling dedication to and deep respect for the brain...

References Ehf MultidrugResistance

Tue, 21 Feb 2012 17:18:06 GMT

Abolhoda A, Wilson AE, Ross H, Danenberg PV, Burt M, Scotto KW 1999 Rapid activation of MDR1 gene expression in human metastatic sarcoma after in vivo exposure to doxorubicin. Clin Cancer Res 5 3352-3356 Atadja P, Watanabe T, Xu H, Cohen D 1998 PSC-833, a frontier in modulation of P-glycoprotein mediated multidrug resistance. Cancer Metastasis Rev 17 163-168 Bates SE 1999 Drug resistance Still on the learning curve. Clin Cancer Res 5 3346-3348 Borst P, Evers R, Kool M, Wijnholds J 2000 A family...

Diagnostic Evaluation Aims and Questions to be Answered IntellectualDisabilities

Tue, 21 Feb 2012 14:18:31 GMT

Together with historical data, the diagnostic evaluation must answer several questions. First, it must determine whether a paroxysmal event is of epileptic nature and whether the patient should be diagnosed with epilepsy. Second, if the diagnosis is epilepsy, it must be assigned to an epilepsy syndrome see Table 4.3 . Third, a possible structural cause of the seizures and ID should be looked for, as well as a possible underlying genetic disorder with epilepsy and ID . Classification with a...

Cyclic Alternating Pattern And Noncyclic Alternating Pattern DuringSleep

Tue, 21 Feb 2012 12:37:41 GMT

CAP is organized in sequences of two or more CAP cycles. Each CAP cycle consists of a phase A and a phase B, each lasting between 2 and 60 s. All CAP sequences begin with a phase A and end with a phase B. In NREM sleep, the phase A patterns are composed of the single or clustered arousal-related phasic events peculiar to the single sleep stages Intermittent alpha rhythms and sequences of vertex sharp waves, in stage 1 Sequences of two or more K-complexes with or without alphalike components and...

Discussion Gql MultidrugResistance

Tue, 21 Feb 2012 11:20:55 GMT

One key finding is the depolarizing GABAa response in human epileptogenic tissue. In the rat neocortex, the reversal potential of GABAa inhibition is governed by a KCl outward transport Thompson et al 1988 originally described in crayfish stretch receptors Deisz amp Lux 1982, Aickin et al 1982 . The GABAa reversal potential, however, is about 15 mV less negative than the chloride gradient due to the partial bicarbonate permeability of GABAa channels Kaila et al 1993 . The depolarizing GABAa...

Monitoring Antiepileptic Drug Serum Levels Epileptic Seizures 2

Mon, 20 Feb 2012 11:41:45 GMT

Facilities for monitoring serum levels are often not available in developing countries, but where they are, it is important that they not be overused. Even in the industrialized world, adjustments in AED regimens are primarily based on clinical grounds, irrespective of the serum levels. Dosage adjustments should always be made on an individual basis and dictated by the performance of a given AED regimen in terms of seizure control on the one hand and side effect profile on the other. Serum...

Transcranial Magnetic Stimulation for the Treatment of Poorly Controlled Partial Epilepsy EpilepsyPatients

Mon, 20 Feb 2012 08:26:11 GMT

Condition s Partial Epilepsy Seizures Study Status This study is completed. Sponsor s National Institute of Neurological Disorders and Stroke NINDS Purpose - Excerpt Transcranial Magnetic Stimulation TMS is a non-invasive technique that can be used to stimulate brain activity and gather information about brain function. It is very useful when studying the areas of the brain related to motor activity motor cortex, corticospinal tract, and corpus callosum . Epilepsy is a condition associated with...

Figure 136 EpilepsyDiagnosis

Mon, 20 Feb 2012 06:22:57 GMT

Dysembryoplastic neuroepithelial tumor DNET . Horizontal post-contrast T1W image of a child with a DNET. The lesion is based in the cortical and subcortical region of the posterior insula on the left. The lesion has minimal mass effect and a cystlike appearance medially with a posterolateral nodule that follows gray matter signal black arrow . gelastic seizures as well as other types of partial and generalized seizures, including atypical absence and drop attacks 20 . Lesions usually are...

Examinations and investigations LobeEpilepsy

Sun, 19 Feb 2012 17:03:25 GMT

In the first patient, the neurological examination was unremarkable. A previous computed tomography scan and EEG were reported as normal. The patient had a magnetic resonance imaging MRI scan, which was also normal. Video-EEG monitoring demonstrated generalized spike-wave discharges interictally as well as in association with her clinical events. In the second patient, the neurological examination was also unremarkable. MRI showed non-specific white matter changes consistent with small vessel...

Meningitis and encephalitis EpilepsyTreatment

Sun, 19 Feb 2012 16:41:29 GMT

The risk of chronic epilepsy following encephalitis or meningitis is almost sevenfold greater than that in the population in general. The increased risk is highest during the first 5 years after infection, but remains elevated for up to 15 years. The risk is much higher after encephalitis relative risk RR 16.2 than bacterial meningitis RR 4.2 or aseptic meningitis RR 2.3 . The presence of early seizures i.e. during the acute phase of the infection greatly influences the risk of subsequent...

Methods For Induction Of Alcohol Dependence And For Monitoring Withdrawal Seizures StatusEpilepticus

Sun, 19 Feb 2012 12:03:49 GMT

Species, Strain, Gender, and Age Considerations As in humans, an alcohol withdrawal syndrome that includes generalized tonic-clonic seizures has been observed in the mouse, rat, cat, dog, monkey, and chimpanzee Ellis and Pick, 1970 Essig et al., 1969 Freund, 1969 Guerrero-Figueroa et al., 1970 Majchrowicz, 1975 Pieper et al., 1972 . In all species, the signs of alcohol withdrawal last for 1 to 3 days, after which behavior returns to normal and there is no enhanced seizure susceptibility....

Examination and investigations Epc LobeEpilepsy

Sun, 19 Feb 2012 09:47:33 GMT

Neurological examination revealed a hypotrophy of the right arm and leg and a mild right-sided central hemiparesis. Cranial computed tomography CT scanning showed a left frontoparietal hypodense region suggestive of infarction and ipsilateral hemispheric atrophy Fig. 38.1 . These findings were confirmed on magnetic resonance imaging. HMPAO Figure 38.1 CT scan demonstrating a left-sided porencephalic lesion and ipsilateral hemispheric hypotrophy. Figure 38.1 CT scan demonstrating a left-sided...

Kouadjo Epilepsy Cote D Ivoire Epileptic Seizures 3

Sun, 19 Feb 2012 09:38:44 GMT

1. Bittencourt PRM, Adamolekum B, Bharucha N et al. ILAE Commission report Epilepsy in the tropics I. Epidemiology, socioeconomic risk factors, and etiology. Epilepsia 1996 37 1121-7. 2. Epilepsy in the developing countries. WHO Chron 1979 33 183-6. 3. World Health Organization. Research protocol for measuring the prevalence of neurological disorders in developing countries. Neurosciences program. Geneva World Health Organization, 1981. 4. Schoenberg BS. Clinical neuroepidemiology in developing...

Hypogenic Paroxysmal Dystonia Or Epilepsy DuringSleep

Sun, 19 Feb 2012 08:17:18 GMT

Lugaresi and Cirignotta 1981 described five patients with recurrent nocturnal episodes of agitation during nonrapid eye movement NREM sleep, consisting of violent limb movements and tonic spasms of 15-45-s duration with preserved consciousness, responsive to carbamazepine. Impressed by the resemblance of these clinical manifestations to the attacks of paroxysmal kine-sigenic choreoathetosis and the absence of epileptiform EEG changes, they coined the term hypnogenic paroxysmal dystonia....

Table 14 EpilepsyDiagnosis

Sun, 19 Feb 2012 03:19:52 GMT

Pros and Cons of Genetic Absence Models in Rats Absence Seizure Models in Genetically Prone Rats Spontaneous seizures Good electroclinical correlation to human absences Developmental discrepancy with the onset of human absence seizures Many spontaneous as well as engineered gene mutations were identified in mice and are now an important tool to study epilepsy syndromes, with the information well exceeding the extent of this chapter. Recently, several excellent reviews on this topic have been...

Symptomatic And Cryptogenic Partial Epilepsies In Infancy EpilepsyDiagnosis

Sun, 19 Feb 2012 03:19:01 GMT

Etiologies of symptomatic partial epilepsies in infants include focal cortical dysplasia FCD , pachygyria, poly-microgyria, low-grade dysplastic changes, heterotopic gray matter, schizencephaly, Sturge-Weber syndrome, tuberous sclerosis, hemimegalencephaly, with or without various neurocutaneous syndromes, dysembryoplastic neuroepithelial tumor, ganglioglioma, gangliocytoma, glialneuronal hamartoma, perinatal postnatal insult, and hippocampal sclerosis with or without cortical dysplasia 18,...

Prognosis in largely untreated populations Epilepsy Treatment 2

Sat, 18 Feb 2012 23:31:45 GMT

The natural history of epilepsy can be derived from untreated or largely untreated epilepsy populations. In less developed countries the vast majority of patients with epilepsy do not receive pharmacological treatment 158 for their epilepsy and would thus be suitable for the study of natural prognosis. In practice, however, once a patient with epilepsy is identified in a study it would be unethical to withhold AED treatment. A prospective study of the natural history is no longer possible once...

Reflex Anoxic Seizures or Reflex Asystolic Syncope RAS IntellectualDisabilities

Sat, 18 Feb 2012 21:50:33 GMT

Gastaut used the term reflex anoxic cerebral seizures to describe all the various syncopes, sobbing spasms, and breath-holding spells that followed noxious stimuli in young children.9 Since 1978, reflex anoxic seizure has been used more specifically to describe a particular type of nonepileptic convulsive event, most commonly induced in young children by an unexpected bump to the head.1 0 Although other terminology, such as pallid white breath-holding and pallid infantile syncope, has been...

Stages of Labor DuringPregnancy

Sat, 18 Feb 2012 15:28:27 GMT

The process of labor and childbirth is divided into three stages The first stage of labor consists of an early phase, which begins with the onset of contractions and the gradual effacement thinning out and dilation opening of the cervix. The next phase of stage one is called the active phase, during which the cervix begins to dilate more rapidly, and the contractions are longer, stronger, and closer together. This is usually the time to call the doctor. The active phase ends with the transition...

Renal stones and oligohydrosis EpilepsyTreatment

Sat, 18 Feb 2012 11:42:05 GMT

A striking difference that has been noted between Japanese studies and the US and European studies is the occurrence of renal stones. In pre-approval studies in Japan, only two patients 0.2 developed urinary stones, compared with a rate of 2.6 in the early studies in the USA and Europe. Table 3.27 Adverse events of zonisamide in double-blind placebo-controlled studies pooled data events occurred in more than 5 of patients. Table 3.27 Adverse events of zonisamide in double-blind...

Tips for Walking During the First Trimester DuringPregnancy

Sat, 18 Feb 2012 08:30:56 GMT

Wear proper walking shoes so that your feet get the support they need, particularly around the ankles and arches. Wear a sun hat and carry a spray bottle of water for cooling off during the summer. The heat from the sun can drain you and stress your body to the point that you become prone to having a seizure. Bring drinking water with you to prevent dehydration. Consider mall walking as an alternative during hot weather. But do not spend too much money while you are at the mall Do not push...

Info Fgm EpilepsyNeuroimaging

Sat, 18 Feb 2012 07:36:35 GMT

FIG. 3.7. Frontal pole, anterior aspect. 3,3' Middle frontal gyrus F2 , superior and inferior parts 4 Middle frontal sulcus reaching 5 5 Frontomarginal sulcus 6,6',6 Superior, middle, and inferior transverse frontopolar gyri 7 Frontomarginal gyrus FIG. 3.8. Lateral aspect of the right frontal lobe. 3 Inferior postcentral sulcus ascending portion 4' Posterior subcentral sulcus 4 Anterior subcentral sulcus 5 Lateral fissure, middle segment 6 Lateral fissure, anterior segment a vertical and b...

Diazepam EpilepsyTreatment

Sat, 18 Feb 2012 00:54:12 GMT

Diazepam was the first benzodiazepine to be used in epilepsy. It is highly lipophilic, allowing rapid entry into the brain, but this high lipid solubility also results in rapid subsequent redistribution into peripheral tissues. It is 90 -99 bound to plasma proteins. The volume of distribution for the free component of diazepam i.e. the active, unbound fraction is 1.1 l kg. The initial half-life is 1 hour. Entero-hepatic circulation result in a second peak in blood levels 6 -8 hours after...

Historical background PostictalPsychosis

Fri, 17 Feb 2012 12:44:40 GMT

Except for the immediate effects of a seizure on mental function, such as complex partial status epilepticus and postictal confusion, modern epileptic psychoses can be categorized into three main types chronic, acute interictal and postictal psychoses. In 1953, Landolt stressed a seesaw relationship between epileptic seizures and psychoses, and proposed the concept of forced normalization. In 1963, Slater made a rather comprehensive report on chronic psychoses in patients with epilepsy Slater...

Prenatal and Perinatal Pathology Epileptic Seizures 3

Fri, 17 Feb 2012 08:39:15 GMT

Poor prenatal or perinatal care resulting in brain damage of the child is often claimed to be a reason for the high prevalence of epilepsy in the tropics.3,31 Unfortunately, very few studies in the tropics define inclusion criteria for this category. In studies in developed countries the presence of prenatal and perinatal events do not appear to be associated with the occurrence of childhood epilepsy when children with cerebral palsy and mental retardation are excluded.32 The USA Collaborative...

Epilepsy arising in the parietal and occipital lobes EpilepsyTreatment

Fri, 17 Feb 2012 06:50:36 GMT

Focal seizures arise from foci in these locations less commonly than from frontal, central or temporal lobe regions. The typical manifestations of the seizures are subjective sensory and visual disturbances Table 1.13 . Additional features are common owing to spread to adjacent cortical regions. Parietal lobe seizures typically comprise sensory manifestations. These may be tingling or a feeling of electricity which can be confined or march in a Jacksonian manner. Sensations of sinking, choking...

Personality PostictalPsychosis

Fri, 17 Feb 2012 04:29:41 GMT

Table 4.4. Seizure precipitants in sleep epilepsy SE n 127 and in awakening epilepsy AE n 90 Table 4.4. Seizure precipitants in sleep epilepsy SE n 127 and in awakening epilepsy AE n 90 Female patients only. Source Janz 1953 . Female patients only. Source Janz 1953 . In JME in particular, we have reported unusual lack of sleep and sudden awakening, and or excessive alcohol consumption, as the most common precipitating factors Janz and Christian, 1957 . Other triggering factors were less common....

Polymicrogyria EpilepsyTreatment

Fri, 17 Feb 2012 04:19:10 GMT

The appearance of small and prominent gyri separated by shallow sulci is known as polymicrogyria. It can be diffuse or localized, and varies in severity as well as extent. The underlying cortex is invariably thickened, and can be un-layered or show an abnormal four-layered structure. The conditions may be a migrational defect in weeks 13 -18 of fetal life, or the result of ischaemia or perfusion failure between weeks 12 and 24 of fetal life. Epilepsy is the leading clinical feature, associated...

Periventricular nodular heterotopia EpilepsyTreatment

Thu, 16 Feb 2012 18:47:36 GMT

The presence of subependymal nodules of grey matter, located along the supralateral walls of the lateral ventricles is known as Periventricular nodular heterotopia synonym bilateral periventricular nodular heterotopia BPNH , subependymal nodular heterotopia SENH . The heterotopia is usually bilateral, although not always. It is much more common in females and conforms to X-linked dominant transmission. One mechanism may be X-chromosome inactivation. The condition is usually lethal in affected...

Neurofibromatosis type 1 EpilepsyTreatment

Thu, 16 Feb 2012 16:22:22 GMT

Neurofibromatosis type 1 NF1 is a common, dominantly inherited genetic disorder, occurring in about 1 in 3000 live births. Almost half of all cases are new mutations. The mutation rate for the NF1 gene is about 1 in 10,000, amongst the highest known for any human gene. It is a large gene, and many different mutations have resulted in the clinical manifestations. Although the penetrance is essentially complete, the clinical manifestations are extremely variable. In NF1, the incidence of epilepsy...

Diagnosing The Specific Type Of Pme EpilepsyDiagnosis

Thu, 16 Feb 2012 02:45:33 GMT

Once the clinician is convinced that a patient has the PME syndrome, the critical question is to determine which specific disorder is present. This is essential for proper clinical and genetic counseling of the family see Treatment'' section . It is now possible to provide a specific diagnosis in life for the majority of patients with PME using clinical methods and minimally invasive investigations. An approach to this problem has been described previously. The clinician should first consider...

Info Kap EpilepsyDiagnosis

Wed, 15 Feb 2012 21:48:00 GMT

Kato M, Dobyns WB. X-linked lissencephaly with abnormal genitalia as a tangential migration disorder causing intractable epilepsy proposal for a new term, interneu-ronopathy. J Child Neurol 2005 63 392-397. OMIM National Center for Biotechnology Information NCBI online Human Genome Resources databases human , including Online Mendelian Inheritance in Man, OMIM McKusick-Nathans Institute for Genetic Medicine, Johns Hopkins University, Baltimore, MD , MIM No. 300382. Buoni S, Zannolli R,...

Search for Genes Influencing Childhood Absence Epilepsy Study EpilepsyPatients

Wed, 15 Feb 2012 20:27:43 GMT

Condition s Childhood Absence Epilepsy Epilepsy Seizures Study Status This study is currently recruiting patients. Sponsor s National Institute of Neurological Disorders and Stroke NINDS Purpose - Excerpt The purpose of our study is to identify gene s involved in the cause of childhood absence epilepsy CAE . Contact s Alissa Rottenstein 212-342-0482 New York Columbia University, Division of Statistical Genetics, New York, New York, 10032, United States Recruiting Alissa Rottenstein 212-342-0482...

References Tgx DrugInteractions

Wed, 15 Feb 2012 18:42:24 GMT

1. Blume WT, Luders HO, Mizrahi E, Tassinari C, van Emde Boas W, Engel J Jr. Glossary of descriptive terminology for ictal semiology report of the ILAE task force on classification and terminology. Epilepsia 2001 42 1212-1218. 2. Hauser WA, Annegers JF, Kurland LT. Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota 1935-1984. Epilepsia 1993 34 453-468. 3. Olafsson E, Hauser WA, Ludvigsson P, Gudmundsson G. Incidence of epilepsy in rural Iceland a population-based study....

THE VAGuS NERVE STIMuLATION THERAPY SYSTEM EpilepsySurgery

Wed, 15 Feb 2012 18:08:48 GMT

Vagus nerve stimulation VNS , which attenuates seizure frequency, severity, and duration by chronic intermittent stimulation of the vagus nerve, is intended for use as an adjunctive treatment with antiepileptic drug AED therapies . As of January 2008, more than 45,000 patients with epilepsy have been implanted with the VNS therapy system worldwide, with approximately 30 of those patients being younger than age 18 at the time of their first implant Approximately one-third of patients receiving...

References Fir LobeEpilepsy

Tue, 14 Feb 2012 16:14:12 GMT

1. M ller JC, Hamer HM, Oertel WH, Rosenow F. Late-onset myoclonic epilepsy in Down's syndrome LOMEDS . Seizure 2001 10 303-6. 2. Veall RM. The prevalence of epilepsy among mongols related to age. J Ment Deficiency Res 1974 18 99-106. 3. Tangye SR. The EEG and incidence of epilepsy in Down's syndrome. J Ment Deficiency Res 1979 23 17-24. 4. McVicker RW, Shanks OE, McClelland RJ. Prevalence and associated features of epilepsy in adults with Down's syndrome. Br J Psychiatry 1994 164 528-32. 5....

AED DosiNG sCHEDuLEs DrugInteractions

Tue, 14 Feb 2012 14:43:32 GMT

Dosing intervals that are inappropriately long can lead to problems with both tolerability, when serum concentrations are too high, and efficacy, when they are too low 71 . This is only a problem for certain drugs, depending on whether the drug truly has a wide therapeutic window. Carbamazepine has a narrow therapeutic window because many people experience toxicity at higher serum concentrations and breakthrough seizures if the concentration is too low. For example, serum concentrations above...

Benign epilepsy with centrotemporal spikes BECTS EpilepsyTreatment

Tue, 14 Feb 2012 04:01:06 GMT

In this common childhood epilepsy syndrome p. 20 , therapy is gratifyingly straightforward and indeed drug treatment is not necessary in all cases. If attacks are infrequent or mild, regular therapy seems inappropriate, especially as some children have only a few attacks before the epilepsy remits. Tonic-clonic seizures carry greater risks than the partial attacks and may tip the balance towards therapy. The partial seizures, when frightening and distressing, can warrant treatment, even if they...

The limbic system PostictalPsychosis

Tue, 14 Feb 2012 03:41:18 GMT

The term 'limbic system' was coined by Maclean 1952 to designate a series of structures originally delineated by Broca 1878 and Papez 1937 , plus the amygdala and its connections, which were believed to play a crucial role in mediating the exchange of information between the thinking brain cortex and the more primal animal brain diencephalon and brain stem . Broca first described the limbic lobe as the area of brain making up the rim of the cortex, including the hippocampus, cingulate cortex...

The Economic Impact Of Epilepsy Epileptic Seizures 2

Mon, 13 Feb 2012 22:12:05 GMT

The direct costs associated with epilepsy include medical expenses associated with medications, hospitalization, and outpatient clinic fees. Costs not typically considered in studies of developed countries include medical services rendered for seizure-related injuries e.g., burns and the high cost of simply reaching a clinic equipped to deal with seizure disorders. Such expenses should be included when assessing the direct cost of epilepsy in developing regions. In Italy, the direct costs of...

Severe Myoclonic Epilepsy In Infancy Dravet Syndrome DrugInteractions

Mon, 13 Feb 2012 20:35:28 GMT

Severe myoclonic epilepsy in infancy SMEI , first described by Dravet, is an early-onset epilepsy syndrome with catastrophic course and poor seizure as well as cognitive outcome. Onset is in the first year of life. Developmentally normal infants present with atypical febrile convulsions focal features, prolonged and episodes of febrile as well as afebrile status epilepticus. The occurrence of afebrile multiple type seizures including myoclonus from the second year of life onwards is accompanied...

Advantages And Limitations Of The Zebrafish Model StatusEpilepticus

Mon, 13 Feb 2012 17:06:01 GMT

The application of our larval zebrafish model to epilepsy research is probably limited only by one's imagination. As discussed in the previous section, a simple application of this model would be to evaluate drugs useful in generalized epilepsy syndromes. One might also consider forward- and FIGURE 4 Response to antiepileptic drugs. a Representative tectal field recordings obtained from a zebrafish bathed in normal Ringer's medium plus 15 mM pentylenetetrazol PTZ baseline and 45 minutes after...

Nocturnal Dissociative Disorder DuringSleep

Mon, 13 Feb 2012 15:59:45 GMT

In dissociative disorder, the major symptom is a disruption of consciousness, identity, memory, or perception that has a psychogenic basis. If the disturbance affects consciousness primarily, awareness is dissociated from behavior and patients engage in complex behaviors for which they are amnestic. Identity is primarily affected in depersonalization disorder and multiple personality disorder American Psychiatric Association, 1994 . While prolonged nocturnal fugues occur in some patients, brief...

Results MultidrugResistance

Mon, 13 Feb 2012 13:05:26 GMT

Generation of epothilone A-resistant cells MDA 435 breast adenocarcinoma cells were incubated in the presence of 10 nM of epothilone A for 5 weeks. Although majority of the cells died, several clones survived the drug selection. Each clone was further expanded in media containing 10 nM epothilone A but only one clone expanded well resulting in a resistant cell line named EA10. EA10 cells served as founder cells for the selection of cells with higher epothilone A resistance that were maintained...

Neuroimaging Studies Epileptic Seizures 3

Mon, 13 Feb 2012 13:03:52 GMT

Both CT and MRI have drastically improved our diagnostic accuracy for NCC by providing objective evidence about the topography of the lesions and the degree of the host inflammatory response against the parasite.30,31 CT scan and MRI findings in parenchymal NCC depend on the stage of development of cysticerci, and include cystic lesions imaging the scolex as a brilliant nodule hole-with-dot image , ring like or nodular enhancing lesions, and punctate calcifications Fig. 2 . Neuroimaging...

Pharmacopoeia EpilepsyTreatment

Mon, 13 Feb 2012 10:59:15 GMT

Use of antiepileptic drugs in different seizure types and syndromes. Partial and secondarily Tonic-clonic generalized tonic- seizures primary Absence Myoclonic West Lennox-Gastaut clonic seizures generalized seizures seizurestt syndromettt syndrometttt Reasonable clinical experience of effectiveness. At the time of writing, gabapentin, levetiracetam, pregabalin, tiagabine and vigabatrin are licensed only for use as add-on therapy in most countries. However, there is extensive published...

CNS infections Epilepsy Treatment 2

Mon, 13 Feb 2012 07:11:02 GMT

CNS infections are a major risk factor for epilepsy. Seizures may be the presenting or the only symptom, or may be one component of a diffuse brain involvement. Using the incidence of epilepsy expected in the general population for reference, the risk of epilepsy among individuals with encephalitis or meningitis is increased almost seven-fold 43 . This increased risk is highest during the first 5 years after infection and tends to decrease thereafter, but it remains elevated up to 15 years. The...

Developmental Changes In Glutamate Neurotoxicity EpilepsyDiagnosis

Mon, 13 Feb 2012 02:02:29 GMT

The immature brain is quite sensitive to neurotoxicity from glutamate and certain of its analogs 33, 60 . Olney discovered a number of years ago that feeding monosodium glutamate to neonatal mice produced characteristic lesions in the hypothalamus 33 . More recently, it has become clear that the receptors that mediate glutamate neurotoxicity respond differently in the immature brain compared with the adult brain. These observations have important implications for the EAA neurotransmitter...

Epidemiology PostictalPsychosis

Sun, 12 Feb 2012 09:21:26 GMT

A majority of studies in this area has been hospital- and institution-based. While the contribution of these studies to the current understanding of psychopathology in epilepsy has been invaluable, the strong selection bias in these studies does make the extrapolation of their findings to the majority of patients with epilepsy, who live in the community, difficult. There have been some population-based studies of psychiatric comorbidity that are summarized here. Most studies have been...

Rhythmic Movement Disorder DuringSleep

Fri, 10 Feb 2012 23:15:01 GMT

Rhythmic movement disorder, characterized by stereotyped repetitive movements of the head and neck, or sometimes the trunk, is also called head-banging, head-rolling, body-rocking, or body-rolling depending on the type of movement. Other terms sometimes employed include jactatio capitis nocturna and rhythmie du sommeil. The movements occur during drowsy wakefulness and stage 1 sleep at a rate of 0.5-2 Hz, rarely during deeper stages of NREM or REM sleep, and may last from a few seconds to as...

Rapid action and parenteral pharmacokinetics EpilepsyTreatment

Fri, 10 Feb 2012 20:37:27 GMT

Fast drug absorption is essential in the treatment of status epilepticus, and thus almost all drugs need to be administered intravenously. Midazolam is the only drug that is absorbed fast enough by the intra-muscular, intra-nasal or buccal routes. Diazepam and other drugs can be given rectally in out-of-hospital situations, but in hospital the intra-venous route is favoured. In order to act rapidly, the drugs need to cross the blood-brain barrier readily, and thus the drugs that are effective...

The Gaba System Neuronal Excitability And Seizure Activity EpilepsyDiagnosis

Fri, 10 Feb 2012 17:43:21 GMT

Gamma-aminobutyric acid is the major inhibitory neu-rotransmitter in brain. It has been extensively characterized and plays a major role in regulating neuronal excitability by controlling chloride permeability 23-25 . Specific binding sites for GABA molecules have been identified in neuronal membrane. Although not all GABA receptors are linked to the chloride channel, a large proportion of these receptors are directly involved in regulating chloride channel function. The major inhibitory effect...

References Xhk Epileptic Seizures 3

Fri, 10 Feb 2012 16:45:30 GMT

1. Forsgren L, Bucht G, Eriksson S et al. Incidence and clinical characterization of unprovoked seizures in adults A prospective population-based study. Epilepsia 1996 37 224-9. 2. Jallon P. Epilepsy and epileptic disorders, an epidemiological marker Contribution of descriptive epidemiology. Epileptic Disord 2002 4 1-13. 3. Hauser WA, Annegers JF, Kurland LT. Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota 1935-1984. Epilepsia 1993 34 453-68. 4. Hauser WA, Hesdorffer DC....

Conclusions Wno StatusEpilepticus

Fri, 10 Feb 2012 15:59:42 GMT

Foremost, the potential usefulness of a zebrafish model of pediatric epilepsy should be evaluated with respect to the type of problem to be solved. In the preceding sections, I have tried to provide examples of the features of this model that are clinically relevant. These features include distinct stages of seizure behavior, evidence of abnormal electrical discharge in a CNS structure, seizure-induced expression of c-fos, and AED sensitivity. There are many more features of this model that...

Paroxysmal Torticollis EpilepticSeizures

Fri, 10 Feb 2012 14:08:49 GMT

Torticollis is an abnormal sustained posture of the head and neck in which the head tilts to one side and the face rotates to the opposite side. In paroxysmal torticollis, the events begin and end suddenly. The attacks can be brief or prolonged. The child is alert and responsive during an attack although the patient may appear uncomfortable and irritable. The EEG is normal during the event. The etiology of the attacks is unknown, although both a focal dystonia and labyrinth dysfunction have...

Statedependent cognitive impairment PostictalPsychosis

Fri, 10 Feb 2012 10:50:11 GMT

It is important to distinguish permanent cognitive impairment on one hand from state-dependent cognitive impairment on the other. The concept of permanent cognitive impairment is readily understood. This may arise from a wide variety of causes of permanent brain damage or dysfunction that may be prenatal, perinatal or postnatal. The concept of state-dependent cognitive impairment is less widely acknowledged Besag, 1994 . What is state-dependent cognitive impairment State-dependent cognitive...

Info Cbu EpilepsyDiagnosis

Fri, 10 Feb 2012 01:26:28 GMT

Adapted from Shinnar et al, 1994 53 . Adapted from Shinnar et al, 1994 53 . have not provided information by epilepsy syndrome. The results from our data 53 are shown in Table 29-2. Overall, patients with both idiopathic and cryptogenic epilepsy syndromes have similar prognosis. However, specific syndromes are associated with a differential risk of relapse. Patients with benign rolandic epilepsy have a particularly favorable prognosis, even if their EEGs are still abnormal, whereas all 4 of our...

Spontaneous Remission Rate in Epilepsy Epileptic Seizures 3

Wed, 08 Feb 2012 19:00:14 GMT

In developing countries, patients may have had epilepsy for long period of time.1 If these patients never remit, prevalence rates for epilepsy in developing countries should be much higher than those found in the developed world.20,21 Indeed some studies in developing countries have reported higher prevalence rates for epilepsy. However, these were all small scale studies of selected populations that may have high rates of CNS degenerative diseases, parasitic diseases or specific epilepsy...

Neuropathological Effects Of Alcohol Withdrawal StatusEpilepticus

Wed, 08 Feb 2012 02:24:37 GMT

In humans, alcohol withdrawal seizures have been associated with ventricular and sulcal enlargement as well as significantly smaller volume of temporal lobe white matter and hippocampal sclerosis Essardas-Daryanani et al., 1994 . In animal models, there is evidence that alcohol intoxication can lead to selective damage to specific brain regions, including the hippocampus Ikonomidou et al., 2000 Walker et al., 1980 . Withdrawal from long-term alcohol consumption can aggravate alcohol-induced...

Articles in scientific journals 1 EpilepsyTreatment

Wed, 08 Feb 2012 01:31:39 GMT

Adab N, Kini U, Vinten J, Ayres J, et al. 2004. The longer term outcome of children born to mothers with epilepsy. J Neurol Neurosurg Psychiatry, 75 1575-83. Adab N, Tudur SC, Vinten J, Williamson P, and Winterbottom J. 2004. Common antiepileptic drugs in pregnancy in women with epilepsy. Cochrane Database Syst Rev, 3 CD004848. American Academy of Pediatrics. Committee on Quality Improvement, Subcommittee on Febrile Seizures. 1999. Practice parameter long-term treatment of the child with simple...

Nonepileptic seizures and dissociation PostictalPsychosis

Wed, 08 Feb 2012 00:44:04 GMT

Epileptologists frequently encounter patients who present with paroxysmal events that, despite resembling epileptic episodes, are actually nonepileptic. Indeed, as many as 50 of patients referred to specialist epilepsy centres may turn out not to have epilepsy Francis and Baker, 1999 . While some nonepileptic seizures may be attributable to physical causes other than epilepsy see Gates and Erdahl, 1993 , a demonstrable organic basis is absent in many such cases. Of these, some are attributable...

Potential Mechanisms Of Seizure Associated Slow Waves PyramidalCells

Tue, 07 Feb 2012 22:31:43 GMT

It is not clear at this moment whether slow waves that occur only at the seizure onset and those that gradually appear during seizure development or at seizure termination are generated by the same or different mechanisms. To the best of our knowledge there are no publications that have studied mechanisms of generation of these waves in the same experimental environment. The majority of existing publications are dedicated to the analysis of mechanism of DC shift during development of acutely...

References Pck MultidrugResistance

Tue, 07 Feb 2012 21:02:37 GMT

Allen JD, Brinkhuis RF, van Deemter L, Wijnholds J, Schinkel AH 2000 Extensive contribution of the multidrug transporters P-glycoprotein and Mrp1 to basal drug resistance. Cancer Res 60 5761-5766 Angeletti RH, Novikoff PM, Juvvadi SR, Fritschy JM, Meier PJ, Wolkoff AW 1997 The choroid plexus epithelium is the site of the organic anion transport protein in the brain. Proc Natl Acad Sci USA 94 283-286 Belinsky MG, Bain LJ, Balsara BB, Testa JR, Kruh GD 1998 Characterization of MOAT-C and MOAT-D,...

Introduction 1 PostictalPsychosis

Tue, 07 Feb 2012 15:52:27 GMT

The association between epilepsy and psychiatric disorders has a long and chequered history. For centuries seizures were considered to be a form of demonic possession. Beginning late in the nineteenth century, considerable attention has been directed towards cataloguing, describing and understanding disorders at the interface between epilepsy and psychiatry, particularly by European neurologists and psychiatrists. However, it is only in the past few decades that any attention has been paid to...

Parahippocampal Gyrus Abnormalities EpilepsyNeuroimaging

Tue, 07 Feb 2012 15:33:08 GMT

Other indirect features of mesial sclerosis commonly seen in these patients are the presence of parahippocampal gyrus atrophy and sometimes signal change. These changes are difficult to visualize but with optimized images one can evaluate the presence of thinning of the underlying white matter and blurring of the gray white matter pattern. This usually depends on having images that assess signal change well Fig. 4.41 . Similarly, changes of the collateral white matter, which is located between...

Remote Symptomatic Epilepsies and Epileptic Syndromes Etiological Spectrum Epileptic Seizures 3

Tue, 07 Feb 2012 04:10:39 GMT

Most of the tropical countries in the world are underdeveloped or developing countries that form part of the so-called Third World. These countries not only have geographic but also social, economic, and ethnic differences as compared to the northern countries of the world. Consequently, there are substantial differences in the relationship between health and disease. The socioeconomic structure of developing countries is marked by profound contrasts. A small percentage of the population has...

References Fby Epileptic Seizures 3

Mon, 06 Feb 2012 17:34:48 GMT

1. Jallon P, Dartigues JF. Epidemiologic descriptive des epilepsies. Rev Neurol 1987 143 341-50. 2. Dano P. Une pilepsie en milieu tropical. Med Trop 1994 54 219-22. 3. Farnarier G, Moubeka-Mounguengui M, Kouna P et al. Epilepsies dans les pays tropicaux en voie de d veloppement tude de quelques indicateurs. Epilepsies 1996 8 189-213. 4. Preux PM, Dumas M. Epilepsie sous les tropiques. Bull Soc Pathol Exot 2000 93 235. 5. World Health Organization Research protocol for measuring the prevalence...

Other vascular disorders EpilepsyTreatment

Mon, 06 Feb 2012 16:57:46 GMT

Cortical venous infarcts are particularly epileptogenic, at least in the acute phase, and may underlie a significant proportion of apparently spontaneous epileptic seizures complicating other medical conditions and pregnancy. Seizures also occur with cerebrovascular lesions secondary to rheumatic heart disease, endocarditis, mitral valve prolapse, cardiac tumours and cardiac arrhythmia, or after carotid endarterectomy. Infarction is also an important cause of seizures in neonatal epilepsy....

The MES and scPTZ tests Epilepsy Treatment 2

Mon, 06 Feb 2012 12:34:20 GMT

The MES and scPTZ seizure models continue to represent the two most widely used animal seizure models employed in the search for new AEDs 5,8,9 and presently remain as the primary screens of the Anticonvulsant Screening Project Fig. 8.1 . As mentioned above, Merritt and Putnam successfully employed the MES test in a systematic screening programme to identify phenytoin 6 . This observation when coupled with the subsequent success of phenytoin in the clinical management of generalized...

Use of Pgp modulators in oncology MultidrugResistance

Sat, 04 Feb 2012 14:42:49 GMT

Before considering specific Pgp modulators and clinical trials in oncology, it would be useful to review the general principles that governed early studies. Some of the earliest modulators first generation were agents that were in clinical use and were found to have a general mild Pgp modulating ability. Examples are verapamil, cyclosporin and tamoxifen. The advantages with these agents were the general familiarity with longer-term use and knowledge of chronic toxicity. Limitations were the...

Examination and Jbt LobeEpilepsy

Fri, 03 Feb 2012 23:49:54 GMT

and symmetric deep tendon reflexes, were unremarkable. The observed left shoulder twitching caused his proximal arm to move in an irregular manner. There was no clonic twitching in the proximal or distal arm or hand. The left shoulder twitching ceased when he was asleep or distracted. The twitching increased if he was asked to move his left arm voluntarily. The intensity of the twitching was variable. Suspecting that the events might be non-epileptic, the neurology house officer applied a...

Anticipatory Guidance Safety Precautions DrugInteractions

Fri, 03 Feb 2012 19:06:02 GMT

Children with epilepsy are at risk for seizure-induced accidents and injuries. At the time of diagnosis, families should be reminded of several basic safety guidelines. It is practical to suggest that care-givers of children with epilepsy should be instructed in basic cardiopulmonary resuscitation. In order to minimize the risk of drowning, people with epilepsy should not bathe or swim alone. When swimming, the child should be supervised by an adult who is capable of assisting in the event of...

Drug resistance in epilepsy human epilepsy MultidrugResistance

Fri, 03 Feb 2012 17:47:38 GMT

S. M. Sisodiya , W.-R. Lin , B. N. Harding , M. V. Squier and M. Thom Epilepsy Research Group, University Department of Clinical Neurology, Department of Neuropathology, Institute of Neurology, and Department of Neuropathology, Institute of Child Health, University College London, Queen Square, London, and Department of Neuropathology, Radcliffe Infirmary, Oxford, UK Abstract. The basis of drug resistance in human epilepsy is not understood. Parallels with resistance in cancer suggest that drug...

References Efg PostictalPsychosis

Fri, 03 Feb 2012 17:20:48 GMT

Alho, K., Winkler, I., Escera, C. et al. 1998 . Processing of novel sounds and frequency changes in the human auditory cortex magnetoencephalographic recordings. Psychophysiology, 35, 211-24. American Psychiatric Association 1987 . Diagnostic and Statistical Manual of Mental Disorders and Related Health Problems Third Edition, Revised DSM-III-R . Washington, DC APA. Barraclough, B. 1981 . Suicide and epilepsy. In Epilepsy and Psychiatry, ed. E.H. Reynolds and M.R. Trimble, pp. 72-6. Edinburgh...

Longterm irreversible effects PostictalPsychosis

Fri, 03 Feb 2012 14:56:50 GMT

The direct effects of seizures will thus dissolve in the majority of the patients after the seizures are adequately controlled. Although some experimental studies, using several animal models, found damage to the hippocampus and related limbic structures after a single prolonged generalized or limbic seizure Meldrum, 1997 , there is no convincing evidence for similar effects in humans Holmes, 1991 . Even with high seizure frequency most cognitive effects will therefore dissolve after seizure...

outcome Raz EpilepsySurgery

Fri, 03 Feb 2012 11:21:24 GMT

As in CSE, the outcome of NCSE is related to the underlying etiology. This is especially so with acute encephalopathies associated with NCSE or NCS . To date, no pediatric studies have shown a worse outcome in patients with NCSE or NCS, and it is thought that electrographic seizure activity may be an additive stress to the injured brain Although not as severe as in CSE, cerebral hemodynamic alterations do occur in complex partial SE but tend to be more focal 1 . NCSE may develop after the...

Seizure Sequelae Epileptic Seizures 2

Thu, 02 Feb 2012 20:28:40 GMT

Seizure sequelae can represent either neurologic deficits provoked by acute neuronal exhaustion and other neurochemical changes depressing neuronal function, or injuries sustained during the actual or previous seizures. Scars may offer evidence of previous seizure-related injuries. The presence of scars probably indicates the need to improve seizure control. Scar identification offers an opportunity to educate the patient and his or her relatives about measures to avoid further similar...

The Guideline Development Group ClonicSeizures

Thu, 02 Feb 2012 17:09:24 GMT

Dr Maria Elena Farrugia Secretary Ms Sheena Bevan Professor Martin Brodie Ms Eleanor Caldwell Ms Francesca Chappell Dr Roger Cull Dr Duncan Davidson Dr Rod Duncan Dr Ali El-Ghorr Dr Janet Fitton Dr Linda Gerrie Dr Rod Gibson Dr Ruth Gillham Dr Margaret Jackson Dr Stewart Jarvie Ms Hilary Mounfield Ms Fiona Needleman Ms Angela Norman Dr Anne O'Hare Dr Mary O'Regan Dr Andrew Orr Dr Pauline Robertson Dr Norman Smith Dr Linda Stephen Consultant Neurologist, Ninewells Hospital, Dundee Specialist...

What Training Is Available For Neurologists Or Epileptologists In Evaluation And Treatment Of Psychiatric Disorders TemporalLobe

Thu, 02 Feb 2012 16:08:48 GMT

Medical school students generally have basic science and clinical exposures in both neurology and psychiatry. A psychiatry clerkship is mandated at most medical schools, while the neurology clerkship is more variable, ranging from no mandatory exposure to 2 4 weeks of neurology, and sometimes including combined time in neurology and psychiatry or neurosurgery. The core curriculum for these clerkships certainly includes some multidisciplinary education, but the level of sophistication of the...

Shift Of Balance Between Excitation And Inhibition As Seizure Triggering Factor PyramidalCells

Thu, 02 Feb 2012 10:08:54 GMT

It is widely accepted that the development of epileptiform activity results from a shift in the balance between excitation and inhibition towards excitation Dichter and Ayala, 1987 Galarreta and Hestrin, 1998 Nelson and Turrigiano, 1998 . A well-known experimental manipulation to elicit acute seizures consists of reducing inhibition Matsumoto and Ajmone-Marsan, 1964a, 1964b Prince, 1978 Gutnick et al., 1982 Chagnac-Amitai and Connors, 1989a, 1989b Steriade et al., 1998 reviewed in McNamara,...

Paul B Pritchard III MD EpilepticSeizures

Thu, 02 Feb 2012 04:01:58 GMT

rolactin PRL is a peptide secreted II by acidophilic pituitary lactomorph I cells under the dual control of a dopaminergic prolactin inhibiting factor PIF and serotonergic prolactin releasing factor PRF . Thyrotropin releasing factor TRF promotes the release of PRL and thryrotopin TSH , whereas estrogen releases PRL via direct stimulation of the pituitary 1 . Normal adults exhibit little change in serum PRL during waking hours, except for brief elevations after naps 2 . Multiple nocturnal PRL...

Info Wth EpilepsyNeuroimaging

Thu, 02 Feb 2012 01:02:35 GMT

FIG. 3.18. Intraventricular aspect of the right hippocampus. The temporal horn of the lateral ventricle has been opened and the choroid plexuses have been removed. FIG. 3.18. Intraventricular aspect of the right hippocampus. The temporal horn of the lateral ventricle has been opened and the choroid plexuses have been removed. 2 Hippocampal head digltationes hippocampi 6 Splenium of the corpus callosum 7 Calcar avis in the occipital horn 10 Uncal recess of the temporal horn the amygdala...

Ring Chromosome 20 Syndrome IntellectualDisabilities

Wed, 01 Feb 2012 22:09:21 GMT

Ring chromosome 20 is a rare disorder characterized by ring-shaped chromosome 20, learning disabilities, seizures that are generally resistant to AED, behavioral problems, and dysmorphic features. Ring 20 r 20 syndrome was first described by Atkins and colleagues,54 and more than 30 cases have been reported so far. The majority of cases describe severe intractable seizures, but some very rare cases are reported without seizures, probably due to phenotype variation. Ring chromosomes are caused...

Intermittent explosive disorder in epilepsy PostictalPsychosis

Wed, 01 Feb 2012 16:21:47 GMT

In the past, few studies have addressed the relationship between different psycho-biological factors like brain pathology, IQ and demographic background, and aggression in epilepsy. While Rodin found more evidence of organic brain disease Rodin, 1973 , and Falconer 1973 reported an increased incidence of mesial temporal lobe sclerosis in aggressive patients with temporal lobe epilepsy TLE , Herzberg and Fenwick did not find any relationship between specific electroencephalography EEG or...

Introduction Tmj PostictalPsychosis

Wed, 01 Feb 2012 13:31:04 GMT

Psychogenic pseudoseizures are paroxysmal events which mimic epileptic seizures. While patients suffering from these symptoms are referred to neurologists because they are mistakenly believed to have epilepsy, neurologists consider the underlying disorder to be of psychological aetiology. Our observations on the nature of pseudoseizures are based on a carefully studied sample of 100 patients with pseudo-seizures evaluated over a period of 5 years at the University of Michigan Medical Center....

Contributors TemporalLobe

Tue, 31 Jan 2012 21:48:05 GMT

Kenneth Alper Departments of Psychiatry and Neurology, NYU Comprehensive Epilepsy Center, New York University School of Medicine, New York, NY 10016, USA G. A. Baker Division of Neurological Science, Clinical Sciences Centre for Research and Education, Lower Lane, Liverpool L9 7LJ, UK John Barry Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA David W. Dunn Department of Psychiatry and Neurology, I ndiana University School of Medicine, Indianapolis, IN 46202,...

Suppression of subclinical epileptic activity EpilepsyTreatment

Tue, 31 Jan 2012 20:13:00 GMT

Antiepileptic drug therapy as a rule should be aimed at suppressing seizures and not the reduction of EEG activity. However, in selected situations, therapy can be targeted at EEG disturbances where these are considered to be having adverse clinical effects 'subclinical activity' . These include reduction of 3 Hz spike-wave paroxysms in children with absence seizures abolition of EEG changes in the Landau-Kleffner syndrome pp. 25-6 abolition of photosensitivity in photosensitive epilepsy...

Genetic models Epilepsy Treatment 2

Tue, 31 Jan 2012 18:43:04 GMT

Until recently, genetic models of epileptic disorders had to rely on animals with an inherent susceptibility to display seizure activity. However, recent advances have made it possible to study the effects of genetic modification and how these subtle changes lead to epilep-togenesis at the cellular level. Moreover, a greater understanding of the anatomical and physiological adaptations that occur following the expression of the 'epileptic gene' may pave the way for improved pharmacotherapy of...

Parasomnia Overlap Disorder DuringSleep

Tue, 31 Jan 2012 17:52:46 GMT

Our center has reported on a group of 33 RBD patients with PSG-docu-mented overlapping NREM-REM sleep motor parasomnias consisting of sleepwalking, sleep terrors, and RBD Schenck et al., 1997b . Mean age was 34 14 years mean age of parasomnia onset was 15 16 years range 1-66 70 n 23 were males. An idiopathic subgroup n 22 had a significantly earlier mean age of parasomnia onset 9 7 years than a symptomatic subgroup n 11 27 23 years whose parasomnia began with neurological disorders, n 6...

Progressive myoclonic epilepsy PME EpilepsyTreatment

Tue, 31 Jan 2012 16:46:39 GMT

This is a rather specific phenotype, which can be caused by a variety of genetically determined neurological disorders Table 1.26 . In most parts of the world there are six common underlying conditions mitochondrial disorders, Unverricht-Lundborg disease, dentato-rubro-pallido-luysian atrophy DRPLA , Lafora body disease, neuronal ceroid lipofuscinosis, and sialidosis. The term progressive myoclonic epilepsy should be confined to those cases where the predominant clinical symptom is myoclonus....

Accessing The Cocodat Database PyramidalCells

Tue, 31 Jan 2012 14:56:49 GMT

The CoCoDat database can be freely downloaded as a Microsoft Access 2000 database mdb file from http www.cocomac.org cocodat along with a manual detailing the procedures for entering, querying and extracting datasets. CoCoDat is copy-lefted under the GNU General Public License http www.gnu.org licenses gpl.html . By opening the database, the user is automatically taken to the central CoCoDat SwitchBoard see Figure 3.1 that gives access to all forms for entering and retrieving data....

References Ojx Epileptic Seizures 3

Tue, 31 Jan 2012 11:46:36 GMT

1. Gastuat H. Dictionary of Epilepsy Part I. Geneva World Health Organization, 1973. 2. Mani KS, Gopalakrishnan PN, Vyas JN et al. Hot-water epilepsy - A peculiar type of reflex epilepsy, a preliminary report. Neurology India 1968 16 107-10. 3. Mani KS, Mani AJ, Ramesh CK. Hot water epilepsy, A peculiar type of reflex epilepsy. Clinical and electroencephalographic features in 108 cases. Trans Amer Neurol Assoc 1975 99 224-6. 4. Subrahmanayam HS. Hot-water epilepsy. Neurology India 1972 20 Suppl...

Epilepsy and dissociation PostictalPsychosis

Tue, 31 Jan 2012 09:59:33 GMT

Although the differential diagnosis of ICD-10 and DSM-IV dissociative disorders explicitly requires the exclusion of symptoms with an identifiable neurological basis, many of the phenomena associated with epilepsy, particularly temporal lobe epilepsy, have been regarded as dissociative in nature Devinsky et al., 1989 Good, 1993 . Indeed, ICD-10 includes a specific category for dissociative disorders due to a general medical condition, which encompasses many of the symptoms exhibited by...

Table 45 MRI Characteristics of Astrocytic Neoplasms EpilepsyNeuroimaging

Tue, 31 Jan 2012 04:55:46 GMT

adult Homogeneous intensity Variable adult Cystic Demarcated Common dense adult Heterogeneous Common irregular Oligodendrogliomas are histologically characterized by the presence of compact groups of large, rounded cells with empty cytoplasm Fig. 4.65 . In almost half the cases, the tumors are mixed with glial components. Calcifications are frequent, with calcium deposits in the intrinsic blood vessels 393, 397-399 . These tumors are less frequent than astrocytomas and also infrequent in our...