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Headache Nov 2016
Topics: Epilepsy; Humans; Migraine Disorders; Olfaction Disorders
PubMed: 27869997
DOI: 10.1111/head.12989 -
Epilepsy & Behavior : E&B Aug 2019The semiology of auras is essential to presurgical evaluation of patients with focal epilepsy. To assess the localizing and lateralizing value of palpitation aura in...
The semiology of auras is essential to presurgical evaluation of patients with focal epilepsy. To assess the localizing and lateralizing value of palpitation aura in focal epilepsy, we retrospectively analyzed the demography, electroclinical, neuroimaging, surgical, pathology data, and outcomes of 114 patients with focal epilepsy and the palpitation aura occurrence in relation to epileptogenic (temporal vs extratemporal, left vs right) origin. Out of 114 patients (mean age, 23.44 ± 9.69 years), 17 (14.9%) patients experienced palpitation as the first aura. Twelve had temporal, one had parietal, one had occipital lobe, and three had multiple lobes junction onset seizures. Palpitation aura was observed more frequently in temporal epilepsy: 22.2% of temporal lobe epilepsy (TLE) and 8.3% of extratemporal lobe epilepsy (EX-TLE) exhibited palpitation aura (p = 0.038). However, palpitation aura had no difference between the left or right side: 16.4% with right-sided epilepsy and 13.2% with left-sided epilepsy exhibited palpitation aura (p = 0.634). Thus, our study suggested that palpitation was a frequent aura in patients with focal epilepsy. It is more commonly seen with temporal lobe origin, but it has no lateralizing value.
Topics: Adolescent; Adult; Arrhythmias, Cardiac; Electroencephalography; Epilepsies, Partial; Epilepsy; Female; Functional Laterality; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neuroimaging; Neurosurgical Procedures; Occipital Lobe; Parietal Lobe; Preoperative Care; Retrospective Studies; Temporal Lobe; Treatment Outcome; Young Adult
PubMed: 31182392
DOI: 10.1016/j.yebeh.2019.05.002 -
Neurology Feb 1995In a prospective study lasting 6 months, we recorded on video 108 seizures with aura of 23 patients in an attempt to evaluate the mechanisms involved in the encoding of... (Clinical Trial)
Clinical Trial Comparative Study
In a prospective study lasting 6 months, we recorded on video 108 seizures with aura of 23 patients in an attempt to evaluate the mechanisms involved in the encoding of memories. In 88 of those seizures, we also recorded an EEG. The percentage of auras remembered decreased significantly with increasing severity of the seizures. The recollection of auras was also significantly dependent on the ictal EEG changes during the aura. Ninety-seven percent of the auras without EEG changes, 94% of the auras with unilateral EEG changes, and 73% of the auras with bilateral EEG changes during the aura were remembered. The spread of the ictal EEG pattern during the aura also showed a significant correlation with the severity of the ensuing seizure. Three patients with bitemporal epilepsy made up a considerable proportion of those who never remembered their aura before secondary generalized tonic-clonic seizures (2 of 3) and of those who had a transient postictal amnesia of their aura (2 of 3). The only patient who failed to remember a previously documented isolated aura also suffered from bitemporal epilepsy. During the second part of the study, we questioned whether information provided during the history could be helpful in defining the type of epilepsy syndrome or localizing the EEG seizure pattern of the 80 patients who had been admitted for presurgical epilepsy diagnosis. Localized (regional, unilateral, and independent left and right lateral) EEG seizure patterns occurred in 82% of the 51 patients with auras in their history as compared with 24% of the 17 patients who did not have auras in their history (p < 0.01).
Topics: Amnesia; Electroencephalography; Epilepsies, Partial; Epilepsy, Frontal Lobe; Epilepsy, Temporal Lobe; Functional Laterality; Humans; Memory; Prospective Studies; Seizures; Unconsciousness
PubMed: 7854517
DOI: 10.1212/wnl.45.2.231 -
Current Pain and Headache Reports Aug 2013Headache and epilepsy often co-occur. Epidemiologic studies conducted in the past few years reinforce the notion of a bi-directional association between migraine and... (Review)
Review
Headache and epilepsy often co-occur. Epidemiologic studies conducted in the past few years reinforce the notion of a bi-directional association between migraine and epilepsy. Data on an association between headache (in general) and epilepsy, however, are less clear. Peri-ictal headache often presents with migraine-like symptoms and can be severe. A correct diagnosis and management are paramount. It was demonstrated that cortical hyperexcitability may underlie both epilepsy and migraine. A recent study linked spreading depolarisation, the supposed underlying pathophysiological mechanism of migraine with aura, to epilepsy. Although this study was carried out in patients who had suffered a subarachnoid haemorrhage, the finding may shed light on pathophysiological mechanisms common to epilepsy and migraine.
Topics: Cerebrovascular Circulation; Comorbidity; Cortical Spreading Depression; Epilepsy; Female; Humans; International Classification of Diseases; Male; Migraine Disorders; Mutation; NAV1.1 Voltage-Gated Sodium Channel; Seizures
PubMed: 23801004
DOI: 10.1007/s11916-013-0351-x -
Neurology India 2021The complex relationship between migraine and epilepsy has frequently been described to represent a clinical and electrographic "borderland." These two conditions share... (Review)
Review
BACKGROUND
The complex relationship between migraine and epilepsy has frequently been described to represent a clinical and electrographic "borderland." These two conditions share clinical expressions such as paroxysmal and chronic nature, as well as semiology, particularly visual phenomenon.
OBJECTIVE
We aimed to review the current literature on the overlapping phenomena of migraine and epilepsy.
MATERIALS AND METHODS
We searched the PubMed for relevant literature and conducted a narrative review on migraine and epilepsy.
RESULTS
Migraine and epilepsy share a complex and pathophysiologically intriguing relationship. The International Classification of Headache Disorders, 3 edition (ICHD-3) makes diagnostic provisions for migraine aura-triggered seizures (Subchapter 1.4.4) and headache attributed to epileptic seizure (Subchapter 7.6), the latter being further categorized as 7.6.1 Ictal epileptic headache, and 7.6.2 post-ictal headache. Neurological conditions such as certain channelopathies and epilepsy syndromes exhibit both conditions within their phenotypic spectrum, suggesting shared genetic and molecular underpinnings. Diagnostic confusion may arise, particularly between occipital epilepsy and the visual aura of migraine. Antiseizure medications may be effective for the treatment of migraines that occur in concert with epilepsy.
CONCLUSIONS
Migraine and epilepsy share several clinical features and have intertwined genetic and molecular underpinnings, which may contribute to common pathogenesis. Electroencephalography may be useful as a diagnostic tool in selected cases.
Topics: Electroencephalography; Epilepsy; Headache; Humans; Migraine Disorders; Seizures
PubMed: 34003153
DOI: 10.4103/0028-3886.315994 -
Continuum (Minneapolis, Minn.) Feb 2016
Topics: Epilepsy; Humans
PubMed: 26844727
DOI: 10.1212/01.CON.0000480846.90933.42 -
The Neuroscientist : a Review Journal... Apr 2018Epilepsy is a common and devastating neurological disorder characterized by recurrent and unprovoked spontaneous seizures. One leading hypothesis for the development and... (Review)
Review
Epilepsy is a common and devastating neurological disorder characterized by recurrent and unprovoked spontaneous seizures. One leading hypothesis for the development and progression of epilepsy is that large-scale changes in gene transcription and protein expression contribute to aberrant network restructuring and hyperexcitability, resulting in the genesis of repeated seizures. Current research shows that epigenetic mechanisms, including posttranslational alterations to the proteins around which DNA is coiled, chemical modifications to DNA, and the activity of various noncoding RNA molecules exert important influences on these gene networks in experimental epilepsy. Key findings from animal models have been replicated in humans using brain tissue obtained from living patients at the time of neurosurgical resection for pharmacoresistant epilepsy. These findings have spurred efforts to target epigenetic processes to disrupt or modify epilepsy in experimental models with varying degrees of success. In this review, we will (1) summarize the epigenetic mechanisms implicated in epileptogenesis and epilepsy, (2) explore the influence of metabolic factors on epigenetic mechanisms, and (3) assess the potential of using epigenetic markers to support diagnosis and prognosis. Translation of these findings may guide the development of molecular biomarkers and novel therapeutics for prevention or modification of epileptic disorders.
Topics: Animals; Disease Progression; Epigenesis, Genetic; Epilepsy; Humans
PubMed: 28468530
DOI: 10.1177/1073858417705840 -
MMW Fortschritte Der Medizin Apr 2022It is known from medical practise that patients and physicians can have positive experiences with little-researched and unapproved interventions. Under certain...
BACKGROUND
It is known from medical practise that patients and physicians can have positive experiences with little-researched and unapproved interventions. Under certain circumstances, effects even go beyond the placebo effect.
METHOD
Based on casuistics of chronic pain patients, the question of whether self-medication in the context of a good doctor-patient relationship can optimize the efficacy of cannabinoids and reduce dose and undesirable side effects is investigated. Using medicinal cannabis as an example, a new view on self-medication and medical support is proposed.
RESULTS
The casuistics show that daily requirements (average of approximately 75 mg) for Δtetrahydocannabinol (THC) doses can be reduced. An unaccompanied and risky self-medication can be transformed into an effective therapy with significantly less medical cannabis. The approach consists of tracing the self-medication that has taken place to date and picking up the patient where he has "discovered" something for himself. The specific mode of action of cannabis in chronic diseases can be explained by mechanisms in the endocannabinoid system. Cannabinoids relieve patients in the context of stress, anxiety and depression, which are always involved in chronic diseases. In their physical as well as psychological sensations, patients are strengthened and eventually guided into self-efficacy.
CONCLUSIONS
If the patient has "discovered" cannabis as medicine for himself and can draw on positive experiences, something very powerful can emerge. In addition to the specific effects demonstrated by studies, there are non-specific effects or contextual factors at work that tend to be neglected in evidence-based medicine. These non-specific effects include, above all, those factors through which a patient gives a (subjective) meaning to a specific intervention. A new view on self-medication and medical support in chronic diseases is needed.
Topics: Analgesics; Cannabinoids; Cannabis; Chronic Disease; Epilepsy; Humans; Male; Medical Marijuana; Physician-Patient Relations
PubMed: 35449489
DOI: 10.1007/s15006-022-0768-4 -
Journal of Clinical Neurophysiology :... Oct 2012Patients with parietal lobe epilepsy (PLE) exhibit an electroclinical epilepsy syndrome that is rarely seen even at large epilepsy centers. Clinically, most patients... (Review)
Review
Patients with parietal lobe epilepsy (PLE) exhibit an electroclinical epilepsy syndrome that is rarely seen even at large epilepsy centers. Clinically, most patients with PLE exhibit a somatosensory aura that may include painful dysesthesias, though vertigo, aphasia, disturbances of one's body image also occur, when ictal propagation occurs from the parietal lobe to the supplementary motor area, hypermotor manifestations are noted. When temporolimbic propagation occurs, complex visual or auditory hallucinations and automatisms may appear. Scalp electroencephalogram (EEG) is often nonlocalizing. Ictal EEG is rarely localizing in PLE, and invasive EEG is often required for definitive localization and functional mapping. Recent advances in clinical neurophysiology during the evaluation of patients with refractory partial epilepsy include Ictal magnetic source imaging (MSI). Combined EEG and functional magnetic resonance imaging (EEG-fMRI) may be useful for patients with PLE to refine the localization in patients undergoing a presurgical evaluation. High-frequency oscillations (HFOs) are more concentrated inside the seizure onset zone (SOZ), indicating that they may be used as interictal scalp EEG biomarker for the SOZ. When medical therapy fails, resective epilepsy surgery can result in seizure freedom or significant reduction especially when a lesion is present.
Topics: Anticonvulsants; Brain Mapping; Brain Waves; Electroencephalography; Epilepsy; Humans; Magnetic Resonance Imaging; Neurosurgical Procedures; Parietal Lobe; Periodicity; Treatment Outcome
PubMed: 23027096
DOI: 10.1097/WNP.0b013e31826c9ebc -
Epileptic Disorders : International... Jun 2015Auditory auras are typically considered to localize to the temporal neocortex. Herein, we present two cases of frontal operculum/perisylvian epilepsy with auditory...
Auditory auras are typically considered to localize to the temporal neocortex. Herein, we present two cases of frontal operculum/perisylvian epilepsy with auditory auras. Following a non-invasive evaluation, including ictal SPECT and magnetoencephalography, implicating the frontal operculum, these cases were evaluated with invasive monitoring, using stereoelectroencephalography and subdural (plus depth) electrodes, respectively. Spontaneous and electrically-induced seizures showed an ictal onset involving the frontal operculum in both cases. A typical auditory aura was triggered by stimulation of the frontal operculum in one. Resection of the frontal operculum and subjacent insula rendered one case seizure- (and aura-) free. From a hodological (network) perspective, we discuss these findings with consideration of the perisylvian and insular network(s) interconnecting the frontal and temporal lobes, and revisit the non-invasive data, specifically that of ictal SPECT.
Topics: Adult; Auditory Perceptual Disorders; Epilepsy, Frontal Lobe; Humans; Male; Middle Aged
PubMed: 25895749
DOI: 10.1684/epd.2015.0742