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The International Journal of... Feb 2019Several shortcomings with currently available pharmacotherapy of epilepsy necessitate the search for new drug targets. Paroxysmal depolarization shifts (PDS) represent... (Review)
Review
Several shortcomings with currently available pharmacotherapy of epilepsy necessitate the search for new drug targets. Paroxysmal depolarization shifts (PDS) represent the cellular correlates of electrographic (e.g. interictal) spikes. While the ionic basis of PDS is understood in great detail, controversy exists regarding their proposed implication in epilepsy. To address this issue and to consider potential targetability, this mini-review gives an overview of the ionic conductances contributing to PDS and reflects on the hypotheses of their potential pro-epileptic (epileptogenic) and anti-epileptic roles.
Topics: Disease Progression; Electrophysiological Phenomena; Epilepsy; Humans; Molecular Targeted Therapy
PubMed: 30557621
DOI: 10.1016/j.biocel.2018.12.006 -
Revue Neurologique Sep 2022Migralepsy is a nosographical entity depicting a clinical event whose occurrence seems rather exceptional in view of the comorbidity observed between epilepsy and... (Review)
Review
Migralepsy is a nosographical entity depicting a clinical event whose occurrence seems rather exceptional in view of the comorbidity observed between epilepsy and migraine. Defined more precisely as a migraine aura-triggered epileptic seizure (within the time limit of one hour), it is susceptible to numerous diagnoses by excess, undoubtedly stimulated by the elegance of the term diagnosis coined by Lennox and Lennox in 1960. This review points to the main criticisms, which were given to it, but also to the international recognition brought by the International Classification of Headache Disorders (ICHD 3). In fact, there are undoubtedly clinical cases falling under the strict definition of migralepsy, cases which are rare but relevant for understanding the pathophysiology of the two colliding events: migraine aura and epileptic seizure involving the occipital lobe.
Topics: Epilepsy; Headache; Headache Disorders; Humans; Migraine Disorders; Seizures
PubMed: 35148906
DOI: 10.1016/j.neurol.2022.01.006 -
Sleep Medicine Nov 2014To describe the anatomo-electro-clinical findings of patients with nocturnal hypermotor seizures (NHS) preceded by auditory symptoms, to evaluate the localizing value of...
OBJECTIVE
To describe the anatomo-electro-clinical findings of patients with nocturnal hypermotor seizures (NHS) preceded by auditory symptoms, to evaluate the localizing value of auditory aura.
METHODS
Our database of 165 patients with nocturnal frontal lobe epilepsy (NFLE) diagnosis confirmed by videopolysomnography (VPSG) was reviewed, selecting those who reported an auditory aura as the initial ictal symptom in at least two NHS during their lifetime.
RESULTS
Eleven patients were selected (seven males, four females). According to the anatomo-electro-clinical data, three groups were identified. Group 1 [defined epileptogenic zone (EZ)]: three subjects were studied with stereo-EEG. The EZ lay in the left superior temporal gyrus in two cases, whereas in the third case seizures arose from a dysplastic lesion located in the left temporal lobe. One of these three patients underwent left Heschl's gyrus resection, and is currently seizure-free. Group 2 (presumed EZ): three cases in which a presumed EZ was identified; in the left temporal lobe in two cases and in the left temporal lobe extending to the insula in one subject. Group 3 (uncertain EZ): five cases had anatomo-electro-clinical correlations discordant.
CONCLUSIONS
This work suggests that auditory aura may be a helpful anamnestic feature suggesting an extra-frontal seizure origin. This finding could guide secondary investigations to improve diagnostic definition and selection of candidates for surgical treatment.
Topics: Adult; Aged; Electroencephalography; Epilepsy, Frontal Lobe; Female; Frontal Lobe; Hallucinations; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neuroimaging; Polysomnography
PubMed: 25224073
DOI: 10.1016/j.sleep.2014.06.019 -
Pediatric Neurology Jun 2016Pyridoxine-dependent epilepsy is a rare autosomal recessive epileptic encephalopathy caused by antiquitin (ALDH7A1) deficiency. In spite of adequate seizure control, 75%... (Review)
Review
BACKGROUND
Pyridoxine-dependent epilepsy is a rare autosomal recessive epileptic encephalopathy caused by antiquitin (ALDH7A1) deficiency. In spite of adequate seizure control, 75% of patients suffer intellectual developmental disability. Antiquitin deficiency affects lysine catabolism resulting in accumulation of α-aminoadipic semialdehyde/pyrroline 6' carboxylate and pipecolic acid. Beside neonatal refractory epileptic encephalopathy, numerous neurological manifestations and metabolic/biochemical findings have been reported.
METHODS AND RESULTS
We present a phenotypic spectrum of antiquitin deficiency based on a literature review (2006 to 2015) of reports (n = 49) describing the clinical presentation of confirmed patients (n > 200) and a further six patient vignettes. Possible presentations include perinatal asphyxia; neonatal withdrawal syndrome; sepsis; enterocolitis; hypoglycemia; neuroimaging abnormalities (corpus callosum and cerebellar abnormalities, hemorrhage, white matter lesions); biochemical abnormalities (lactic acidosis, electrolyte disturbances, neurotransmitter abnormalities); and seizure response to pyridoxine, pyridoxal-phosphate, and folinic acid dietary interventions.
DISCUSSION
The phenotypic spectrum of pyridoxine-dependent epilepsy is wide, including a myriad of neurological and systemic symptoms. Its hallmark feature is refractory seizures during the first year of life. Given its amenability to treatment with lysine-lowering strategies in addition to pyridoxine supplementation for optimal seizure control and developmental outcomes, early diagnosis of pyridoxine-dependent epilepsy is essential. All infants presenting with unexplained seizures should be screened for antiquitin deficiency by determination of α-aminoadipic semialdehyde/pyrroline 6' carboxylate (in urine, plasma or cerebrospinal fluid) and ALDH7A1 molecular analysis.
Topics: Epilepsy; Humans; Phenotype
PubMed: 26995068
DOI: 10.1016/j.pediatrneurol.2015.12.013 -
Current Pharmaceutical Design 2017An archaic surgical procedure, the skull trepanning, was introduced in ancient Greece to treat brain derangement, and endured until the 18th century with the same use.... (Review)
Review
An archaic surgical procedure, the skull trepanning, was introduced in ancient Greece to treat brain derangement, and endured until the 18th century with the same use. Hippocrates recognized epilepsy as a common entity and categorized it as a brain disorder, removing any divine origin. He proposed that the excess of black bile and mucus is due to the infiltration of air inside the blood circulation (veins). For him it was a hereditary disease that could be cured. Thus, he suggested a non-invasive treatment based on herbal potions, and a surgical treatment by using the most advanced operation of the era, the open brain drilling, known as trepanning, or trephination, setting the beginning of neurosurgery.
Topics: Epilepsy; History, Ancient; Humans
PubMed: 29076418
DOI: 10.2174/1381612823666171024153144 -
Nevropatologiia I Psikhiatriia 1951
Topics: Epilepsy; Humans
PubMed: 14899607
DOI: No ID Found -
Epilepsy Research Mar 2001The diagnostic value of lack of aura experience in patients with temporal lobe epilepsy (TLE) is unclear.
UNLABELLED
The diagnostic value of lack of aura experience in patients with temporal lobe epilepsy (TLE) is unclear.
PURPOSE
To evaluate possible factors of bitemporal dysfunction in patients with mesial TLE who did not experience an aura in electroencephalography EEG/video monitoring for epilepsy surgery.
METHODS
Ictal scalp EEG propagation patterns of 347 seizures of 58 patients with mesial temporal lobe sclerosis or non-lesional mesial TLE, interictal epileptiform discharges (IED), presence of unilateral mesial temporal lobe sclerosis in visual magnetic resonance imaging (MRI) analysis, prose memory performance, history or not of an aura, and postictal memory or absence of an aura were analyzed. The ictal EEG was categorized as follows. EEG seizure: (a) remaining regionalized, (b) non-lateralized, (c) showing later switch of lateralization or bitemporal asynchronous ictal patterns.
RESULTS
Absent aura in monitoring was significantly correlated with absence of unitemporal MRI sclerosis (P=0.004), bitemporal IED (P=0.008), and propagation of the ictal EEG to the contralateral temporal lobe (P=0.001). Other historical data and interictal prose memory performance were not significantly correlated with absent aura. Ten of 11 patients without aura in monitoring also had absent or rare auras in their history.
CONCLUSIONS
Lack of aura experience strongly correlates with indicators of bitemporal dysfunction such as bitemporal interictal sharp waves and bitemporal ictal propagation in scalp EEG, and absence of lateralized MRI sclerosis in patients with mesial TLE. The fact that absent auras are not correlated with episodic memory suggests a transient memory deficit, probably because of rapid propagation to the contralateral mesial temporal lobe.
Topics: Adolescent; Adult; Child; Electroencephalography; Epilepsy; Epilepsy, Temporal Lobe; Humans; Magnetic Resonance Imaging; Middle Aged; Prospective Studies; Temporal Lobe; Video Recording
PubMed: 11248532
DOI: 10.1016/s0920-1211(00)00195-9 -
Cephalalgia : An International Journal... Feb 2011Convexity subarachnoid haemorrhage (cSAH) has recently been recognised as a cause of recurrent aura-like symptoms, mimicking transient ischaemic attacks (TIAs)....
BACKGROUND AND PURPOSE
Convexity subarachnoid haemorrhage (cSAH) has recently been recognised as a cause of recurrent aura-like symptoms, mimicking transient ischaemic attacks (TIAs). Subarachnoid haemorrhage and recurrent aura-like episodes can occur in patients with cerebral amyloid angiopathy (CAA), which has been the presumed cause in the majority of reported cases. However, this syndrome can occur following cSAH secondary to other conditions, and it is important for clinicians to investigate and manage such patients appropriately.
METHOD
Case series.
RESULTS
We describe two patients who presented with recurrent stereotyped transient neurological symptoms in the setting of acute cSAH identified on MRI. In one patient, SAH occurred secondary to cerebral venous sinus thrombosis. In the other, SAH was due to extension of a traumatic subdural haematoma.
CONCLUSIONS
Conditions other than CAA can cause the clinicoradiological syndrome of cSAH with recurrent TIA-like events. Gradient echo or susceptibility-weighted imaging should be included in the diagnostic work-up of patients presenting with such events. When cSAH is detected, the full differential diagnosis for this should be considered. Aetiologies other than CAA can cause this syndrome and management can vary greatly depending on the underlying cause.
Topics: Aged; Aged, 80 and over; Cerebral Amyloid Angiopathy; Diagnosis, Differential; Epilepsy; Female; Hematoma, Subdural, Intracranial; Humans; Ischemic Attack, Transient; Male; Sinus Thrombosis, Intracranial; Subarachnoid Hemorrhage
PubMed: 20855358
DOI: 10.1177/0333102410384885 -
The International Journal of... Jun 2019Migraine is neurological disorder with a complex pathophysiology. We described the neuropsychological profile of 100 migraineurs (50 with visual aura and 50 without...
AIM
Migraine is neurological disorder with a complex pathophysiology. We described the neuropsychological profile of 100 migraineurs (50 with visual aura and 50 without aura), in interictal phase, compared to 50 matched healthy controls.
MATERIALS AND METHODS
A battery of standardized neuropsychological tests was used to assess attention, memory and executive functions. Beck Depression Inventory and Hamilton Rating Scale for Anxiety were used to evaluate anxiety and depressive symptoms. Severity of disability during daily activities was assessed by Migraine Disability Assessment.
RESULTS
Migraine without aura showed a significant difference in comparison to healthy controls in semantic verbal fluency (p = 0.02), delayed memory (p < 0.001) and set-shifting (p < 0.001). Migraine with aura showed a significant difference in delayed memory (p = 0.001) and set-shifting (p = 0.005) if compared to healthy controls. No significant correlation between cognitive functions and mood was found (HAM-A p = 0.67) (BDI-II p = 0.42).
CONCLUSIONS
Our data showed isolate and specific cognitive deficit during interictal phase in migraine patients. Future studies are need to identify if specific migraine characteristics may affect cognitive functions.
Topics: Adult; Anxiety; Attention; Case-Control Studies; Depression; Disability Evaluation; Epilepsy; Executive Function; Female; Humans; Male; Memory; Migraine Disorders; Neuropsychological Tests
PubMed: 30497314
DOI: 10.1080/00207454.2018.1554658 -
BioFactors (Oxford, England) 2011Voltage-gated calcium channels are a family of integral membrane calcium-selective proteins found in all excitable and many nonexcitable cells. Calcium influx affects... (Review)
Review
Voltage-gated calcium channels are a family of integral membrane calcium-selective proteins found in all excitable and many nonexcitable cells. Calcium influx affects membrane electrical properties by depolarizing cells and generally increasing excitability. Calcium entry further regulates multiple intracellular signaling pathways as well as the biochemical factors that mediate physiological functions such as neurotransmitter release and muscle contraction. Small changes in the biophysical properties or expression of calcium channels can result in pathophysiological changes leading to serious chronic disorders. In humans, mutations in calcium channel genes have been linked to a number of serious neurological, retinal, cardiac, and muscular disorders.
Topics: Animals; Ataxia; Calcium; Calcium Channels; Channelopathies; Epilepsy; Humans; Migraine with Aura
PubMed: 21698699
DOI: 10.1002/biof.158