Purpose:  Hippocampal sclerosis (HS) is the most common pathologic finding in intractable temporal lobe epilepsy (TLE). In many patients, HS is accompanied by an extrahippocampal lesion (EHL). We sought to assess the lobar distribution and side of EHLs in relation to HS in a large consecutive series of patients presenting ...

5-Hydroxytryptamine (5-HT)3 receptor (5-HT3R) antagonists are effective in treating patients with irritable bowel syndrome (IBS) and have anxiolytic effects. Their therapeutic effects are related, in part, to reducing amygdala engagement during expected visceral pain. A single nucleotide polymorphism in HTR3A, c.-42C>T;(C178T; rs1062613), is associated with altered reactivity of the amygdala ...

The purpose of this study was to assess the prevalence of and to identify epidemiologic, genetic, electrophysiologic, and neuroanatomic risk factors for autism spectrum disorders (ASD) in a cohort of patients with tuberous sclerosis complex (TSC). A total of 103 patients with TSC were evaluated for ASD. A retrospective review ...

OBJECTIVE: To clarify the clinical significance of ictal high frequency oscillations (HFO) in the medial temporal lobe. METHODS: This study included 19 patients who underwent intracranial electrode implantation in bilateral temporal lobes and had at least one seizure recorded at 1kHz sampling rate. The characteristics of ictal HFO in the ...

The syndrome of malignant migrating partial seizures in infancy is a devastating, age-specific, epileptic encephalopathy, which still presents an aetiological, pathophysiological and therapeutic problem. In this study, we present two patients who were diagnosed with the disease, based on electroclinical symptoms. The patients were treated with a combination of sodium ...

OBJECTIVE: To validate an improved automated electroencephalography (EEG)-based neonatal seizure detection algorithm (NeoGuard) in an independent data set. METHODS: EEG background was classified into eight grades based on the evolution of discontinuity and presence of sleep-wake cycles. Patients were further sub-classified into two groups; gpI: mild to moderate (grades 1-5) ...

PURPOSE: The effectiveness of VNS was evaluated in thirty-nine encephalopatic patients with drug-resistant epilepsy characterized by multiple seizures and drop attacks. Twenty-five patients were affected by severe epilepsy with multiple independent spike foci (SE-MISF) and fourteen patients by Lennox-Gastaut syndrome (LGS). METHOD: Changes in seizure frequency, cognition, adaptive behaviour and ...

People with epilepsy (PWE) are restricted from driving because of the concern over seizure-related car accidents. We investigated the characteristics of driving in these people and aimed to identify factors associated with driving in those with uncontrolled seizures. Of 290 epilepsy patients, 58% had a driver's license, 40% had driven ...

BACKGROUND AND PURPOSE: The hippocampal atrophy of MDD has been known, but the region shape contractions of the hippocampus in MDD were inconsistent. Spheric harmonic shape analysis was applied to the hippocampus in female patients with unremitting MDD to evaluate morphometric changes of the hippocampus. MATERIALS AND METHOD: Shape analysis ...

Seizures associated with hypothalamic hamartoma (HH) are notoriously intractable to medical therapy, and while surgical resection affords most affected patients with complete or near seizure-freedom, there remains a need to identify alternative treatments. In this retrospective study, we identified six patients from a large cohort of 220 patients with HH ...

PURPOSE: Indoleamine 2,3-dioxygenase (IDO) is a cytokine-inducible enzyme that participates in tryptophan (trp) and serotonin metabolism with an ability to modulate neuroinflammation. Several recent studies have shown associations between cytokines and epilepsy. In this study we investigated whether activation of IDO is associated with epilepsy. METHODS: Kynurenine (kyn)/trp serum ratio, ...

To study cone photoreceptor structure and function associated with mutations in the second intradiscal loop region of peripherin/RDS. High-resolution macular images were obtained with adaptive optics scanning laser ophthalmoscopy and spectral domain optical coherence tomography in four patients with peripherin/RDS mutations and 27 age-similar healthy subjects. Measures of retinal structure ...

Dextromethorphan (DXM) has unique toxicity that may be difficult to diagnose. We present a case of a young woman who presented to our emergency department (ED) initially diagnosed with recurrent seizures.Paramedics brought a 19-year-old woman to the ED. Witnesses noted "shaking," which the patient did not recall. The patient denied ...

This study sought to present clinical and outcome data of patients with idiopathic childhood occipital epilepsy of Gastaut, to validate previously reported characteristics of this epilepsy. The study group was comprised of 12 affected children (three boys and nine girls), with a median age of onset at 10.3 years. Common ...

Background: Escalating focal sensorimotor seizures, progressive neurologic deficit and cognitive decline with associated typical magnetic resonance imaging (MRI) findings or pathological confirmation constitute the syndrome of Rasmussen's encephalitis. Methods: Three patients with this clinical scenario had long-term follow-up after being given the antiviral drug ganciclovir 10 mg/kg/day IV for ten ...

We aimed to evaluate changes in antioxidant status in blood during valproate (VPA) monotherapy of adult patients with epilepsy. Antioxidant enzymes [plasma superoxide dismutase (pSOD), erythrocyte superoxide dismutase (eSOD)] and non-enzymatic indices [concentration of trace elements in serum: selenium, copper, zinc (sZn) and uric acid (UA), as well as the ...

To investigate impairment in discriminating a figure from its background and to study its relation to visual acuity and lesion size in patients with neovascular age-related macular degeneration (AMD). Seventeen patients with neovascular AMD and visual acuity <20/50 were included. Seventeen age-matched healthy subjects participated as controls. Complete ophthalmologic examination ...

BACKGROUND AND PURPOSE: Generalized tonic-clonic seizures (GTCS) comprise a common subsyndrome of idiopathic generalized epilepsy (IGE). Previous studies found that patients with GTCS had structural abnormalities in a few specific brain regions. However, the underlying clinical cause leading to these abnormalities remains unclear. The present study aimed to explore the ...

A 51-yr-old female was referred to our outpatient clinic for the evaluation of generalized edema. She had been diagnosed with idiopathic thrombocytopenic purpura (ITP). She had taken no medicine. Except for the ITP, she had no history of systemic disease. She was diagnosed with systemic lupus erythematosus. Immunosuppressions consisting of ...

OBJECTIVE: To assess the interictal epileptic discharges (IEDs) detection rate of magnetoencephalography (MEG) recordings performed in a new light-weight magnetic shielding (LMSR) concept in a large group of consecutive patients with presumed mesiotemporal lobe epilepsy (MTLE). METHODS: Thirty-eight patients (23 women; age range: 6-63 years) with presumed MTLE were prospectively ...

False lateralization of ictal onset by scalp EEG has been reported in patients with severe hippocampal sclerosis associated with hemispheric lesions or atrophy. There has been no report of cases of false lateralization by scalp EEG in patients without detectable structural abnormalities on MRI, or in patients with neocortical temporal ...

BACKGROUND:: Epilepsy surgery for MRI-negative patients has a less favorable outcome. OBJECTIVE:: Detection of subclinical abnormal gyration (SAG) patterns and its potential contribution to assessment of the topography of the epileptogenic zone (EZ) is addressed in MRI-negative frontal lobe epilepsy (FLE) patients. METHODS:: Between September 1998 and July 2005, 12 ...

BACKGROUND:: WHO grade I meningiomas are common and mostly benign primary brain tumors. Little is known about the health-related quality of life (HRQOL) of meningioma patients. Objective: To investigate the long-term HRQOL in meningioma patients and its association with cognitive deficits and epilepsy. METHODS:: HRQOL was assessed by the SF-36 ...

To asses the characteristics of severe action myoclonus in three patients with progressive myoclonus epilepsy (PME) due to sialidosis. We assessed EEG-EMG coherence, relative power (RP) and bandwidth (BW) of the EMG-peak associated with myoclonus; we also evaluated somatosensory evoked potentials and long-loop reflexes (LLRs). We compared the findings with ...

Purpose:  The phenotypic and etiologic spectrum in adults with nodular heterotopias (NHs) has been well characterized. However, there are no large pediatric case series. We, therefore, wanted to review the clinical features of NHs in our population. Methods:  Hospital records of 31 patients with pathology or imaging-confirmed NHs were reviewed. ...

This study aims to investigate μ-calpain expression profiles in the anterior temporal neocortex in patients with intractable epilepsy, and to determine whether its pattern of expression is related to pathological changes seen in these patients. The study subjects consisted of 30 patients with intractable epilepsy and a control group of ...

Since the first description of transient global amnesia (TGA) in 1964, its etiology has remained obscure. Reversible diffusion weighted imaging (DWI) hyperintensities in the hippocampus have been found on MRI of some patients with TGA during acute events. The implication of this is not well understood. We identified 47 patients ...

Ictal automatisms of fear or sadness, of which the patient is unaware and which are not preceded by a corresponding emotion, have not been well characterized. Of 557 patients admitted for video/EEG monitoring, 2 (0.36%) were identified who had automatisms of fear and sadness. One patient was found to have ...

We used diffusion tensor imaging to characterize microstructural changes and their associations with cognition in Chinese patients with frontal lobe epilepsy (FLE). We examined 18 adult patients with FLE and 20 healthy controls. Compared with normal controls, patients with FLE had increased mean diffusivity (MD) in the right frontal lobe ...

BACKGROUND: Propofol dose requirement for loss of consciousness (LOC) in epilepsy patients would be probably affected by increasing factors [development of tolerance, up-regulated γ-aminobutyric acid (GABAA) receptors, or antiepileptic activity of propofol] and reducing factors [synergistic interaction between propofol and antiepileptic drugs (AEDs) or reduced neuronal mass in cortex] in ...

Acta Ophthalmol. 2011: 89: e89-e94 ABSTRACT.: Purpose:  To report fundus autofluorescence and optical coherence tomography (OCT) findings in patients with blunt ocular trauma. Methods:  Six eyes of six consecutive patients with blunt ocular trauma were evaluated in an observational case series using colour fundus photography, the Heidelberg Retina Angiograph 2 ...

This study aimed to describe the Rarebit (RB) visual field and optic nerve size/morphology in patients treated with allogeneic stem-cell transplantation (SCT) in childhood, and to determine the impact of ocular status and conditioning regimens such as total body irradiation (TBI), chemotherapy and/or immunosuppressive drugs on the RB visual field. ...

We investigated a relationship between the FLAIR signal found in mesial temporal sclerosis (MTS) and inflammation. Twenty nine patients were selected through clinical and MRI analysis and submitted to cortico-amygdalo-hippocampectomy to seizure control. Glutamate, TNFα, IL1, nitric oxide (NO) levels and immunostaining against IL1β and CD45 was performed. Control tissues ...

: The development of newer diagnostic technologies has reduced the need for invasive electroencephalographic (EEG) studies in identifying the epileptogenic zone, especially in adult patients with mesial temporal lobe epilepsy and hippocampal sclerosis (MTLE-HS). : To evaluate ictal single photon emission computed tomography (SPECT) in the evaluation and treatment of ...

Purpose:  To clarify the role of epilepsy and genetic background in determining the cognitive outcome of patients with Dravet syndrome. Methods:  In this retrospective study, we reviewed the clinical history and cognitive development of 26 patients who had been followed with standardized evaluations since seizure onset. The cognitive outcome was ...

Purpose:  Early onset absence seizures have been considered a rare heterogeneous group with a poor prognosis. Only few patients may be categorized into well-known syndromes. We have evaluated electroclinical features, evolution, and the nosologic boundaries of early onset absence seizures. Methods:  Forty-six neurologically normal patients with absence seizures associated with ...

This retrospective cross-sectional study was carried out to study the association between different levels of hyponatremia and the occurrence of epileptic seizures in patients without a prior epilepsy diagnosis. We identified from the hospital database, 363 inpatients of a Swedish County hospital who between March 2003 and August 2006 were ...

In temporal lobe epilepsy (TLE) there may be functional abnormalities or structural lesions that can manifest as a central auditory processing disorder, which is defined as a disorder in the recognition, discrimination, ordering, grouping, and localization of sounds, with emphasis on the processing of nonspeech sounds. We performed frequency pattern, ...

Object Seizures occur in approximately 80% of patients with low-grade gliomas (LGGs). The majority of patients are treated with anticonvulsant monotherapy; however, many patients require multidrug therapy, or their seizures are refractory to antiepileptic drugs altogether. The oral alkylating agent temozolomide has emerged as a potential initial treatment option for ...

Many patients with hypothalamic hamartomas present in infancy with gelastic seizures of subcortical origin, but later develop additional seizure types, including complex partial, tonic, and generalized tonic-clonic seizures. The basic cellular mechanisms responsible for this evolution in seizure types are unknown. Using voxel-based morphometry of T1 weighted MRI scans we ...

Both ictal asystole and eating reflex seizures are rare conditions that are closely related to temporal lobe epilepsy (TLE). Patients exhibiting these two conditions simultaneously have not been previously reported. We describe two unusual cases in which patients with left TLE were confirmed to have ictal asystole and eating epilepsy ...

OBJECTIVE: The goal of this study was to define the long-term outcome of absence epilepsy presenting before the age of 3years. METHODS: We retrospectively studied the medical records of 40 children from eight neuropediatric centers in Italy with respect to the personal and family histories of epilepsy or febrile seizures, ...

Conventional EEG (CEEG) in neonates is considered the gold standard for evaluating EEG background and detecting electrographic seizures. However, CEEG is expensive and cumbersome for long-term monitoring. A simplified method, amplitude-integrated EEG (AEEG) has been rapidly adopted to accomplish the same goals. The purpose of this study was to measure ...

Purpose:  To assess the efficacy and tolerability of chronic high-frequency deep brain stimulation (DBS) in adult patients with progressive myoclonic epilepsy (PME) syndromes. Methods:  Five adult patients (four male, 28-39 years) with PME underwent chronic high-frequency DBS according to a study protocol that had been approved by the local ethics committee. ...

The unpredictable and random occurrence of seizures is of the most distressful issue affecting patients and their families. Unattended seizures can have serious consequences including injury or death. The objective of this study is to develop a small, portable, wearable device capable of detecting seizures and alerting patients and families ...

Forty-four patients presenting with first-ever seizure within 24 h of illicit use of amphetamine or related analogs (amphetamine-associated seizures, AAS) were identified over 8 years. Patients with AAS were compared to control groups of other first-ever seizure patients (provoked n = 126 and unprovoked n = 401). Cumulative probability of ...

Purpose:  Several studies have suggested that interictal regional delta slowing (IRDS) carries a lateralizing and localizing value similar to interictal spikes and is associated with favorable surgical outcomes in patients with temporal lobe epilepsy (TLE). However, whether IRDS reflects structural dysfunction or underlying epileptic activity remains controversial. The objective of ...

Gelastic seizure is an uncommon type of seizure which is characterized by recurrent bouts of unprovoked and stereotyped laughter. It is commonly observed in patients with hypothalamic hamartoma, while its association with other cerebral lesions is rare. The patient was a 15-year-old right-handed male. His chief complaints were recurrent onsets ...

To describe the structural changes in the transition zone from relatively healthy retinal regions to severely affected regions in patients with retinitis pigmentosa (RP) using frequency domain optical coherence tomography (fdOCT). FdOCT line scans of the horizontal meridian were obtained from one eye of 13 patients with RP and 30 ...

Purpose:  The aim of the study was to reveal the relationships between the tuber count of the brain found in patients with tuberous sclerosis complex (TSC) and their cognitive outcome. Methods:  A single-center, retrospective analysis was performed of patients with documented TSC seen from 1988 to 2010 at the Children's ...