Temporal lobe epilepsy following maintenance electroconvulsive therapy-Electrical kindling in the human brain?

Background: Electroconvulsive therapy (ECT) involves the induction of a generalized seizure with an electrical current and has been used worldwide when treating medically refractory psychiatric illness. Here we describe a patient with no prior history or risk factors for epilepsy who developed temporal lobe epilepsy after chronic treatment of ECT. Methods: A 16-year-old right-handed boy with severe refractory depression received ECT treatment every 10 days for 8 months. Six months into his ECT treatment, the patient developed seizures and was admitted to a pediatric epilepsy monitoring unit. Results: Initial clinical events included lightheadedness, diaphoresis, and nausea with associated kaleidoscopic vision changes. Seizures progressed to confusion, fear and paranoia by the time the patient was admitted for monitoring. Long-term video EEG captured many focal seizures with impaired awareness, all originating from both temporal lobes. MRI was normal. ECT was terminated and the patient started on carbamazepine. He has been seizure free for the past 2 years on medication Conclusions: While rare, we present a case of a patient with no prior risk factors for epilepsy who developed temporal lobe epilepsy after chronic ECT treatment. Although ECT is an indispensable treatment for many medically refractory psychiatric illnesses, we suggest caution in young patient undergoing ECT.

Download Full-text

Commentary on Schotte et al. “Development of temporal lobe epilepsy during maintenance electroconvulsive therapy: A case of human kindling?”

Epilepsia Open ◽

10.1002/epi4.12296 ◽

2019 ◽

Vol 4 (1) ◽

pp. 206-209 ◽

Cited By ~ 1

Author(s):

Solomon L. Moshé ◽

Aristea S. Galanopoulou

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Electroconvulsive Therapy

Download Full-text

Multimedia human brain database system for surgical candidacy determination in temporal lobe epilepsy with content-based image retrieval

10.1117/12.476296 ◽

2003 ◽

Author(s):

Mohammad-Reza Siadat ◽

Hamid Soltanian-Zadeh ◽

Farshad A. Fotouhi ◽

Kost Elisevich

Keyword(s):

Temporal Lobe Epilepsy ◽

Human Brain ◽

Image Retrieval ◽

Temporal Lobe ◽

Database System ◽

Content Based Image Retrieval

Download Full-text

The Relationship between Glucose Metabolism, Resting-State fMRI BOLD Signal, and GABAA-Binding Potential: A Preliminary Study in Healthy Subjects and Those with Temporal Lobe Epilepsy

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.2014.228 ◽

2015 ◽

Vol 35 (4) ◽

pp. 583-591 ◽

Cited By ~ 59

Author(s):

Allison C Nugent ◽

Ashley Martinez ◽

Alana D'Alfonso ◽

Carlos A Zarate ◽

William H Theodore

Keyword(s):

Glucose Metabolism ◽

Temporal Lobe Epilepsy ◽

Human Brain ◽

Temporal Lobe ◽

Resting State ◽

Healthy Subjects ◽

Binding Potential ◽

Bold Signal ◽

Healthy Human ◽

The Brain

Glucose metabolism has been associated with magnitude of blood oxygen level-dependent (BOLD) signal and connectivity across subjects within the default mode and dorsal attention networks. Similar correlations within subjects across the entire brain remain unexplored. [18F]-fluorodeoxyglucose positron emission tomography ([18F]-FDG PET), [11C]-flumazenil PET, and resting-state functional magnetic resonance imaging (fMRI) scans were acquired in eight healthy individuals and nine with temporal lobe epilepsy (TLE). Regional metabolic rate of glucose (rMRGlu) was correlated with amplitude of low frequency fluctuations (ALFFs) in the fMRI signal, global fMRI connectivity (GC), regional homogeneity (ReHo), and gamma-aminobutyric acid A—binding potential (GABAA BPND) across the brain. Partial correlations for ALFFs, GC, and ReHo with GABAA BPND were calculated, controlling for rMRGlu. In healthy subjects, significant positive correlations were observed across the brain between rMRGlu and ALFF, ReHo and GABAA BPND, and between ALFFs and GABAA BPND, controlling for rMRGlu. Brain-wide correlations between rMRGlu and ALFFs were significantly lower in TLE patients, and correlations between rMRGlu and GC were significantly greater in TLE than healthy subjects. These results indicate that the glutamatergic and GABAergic systems are coupled across the healthy human brain, and that ALFF is related to glutamate use throughout the healthy human brain. TLE may be a disorder of altered long-range connectivity in association with glutamate function.

Download Full-text

Temporal lobe epilepsy: a unique window into living human brain epigenetic gene regulation

Brain ◽

10.1093/brain/awu386 ◽

2015 ◽

Vol 138 (3) ◽

pp. 509-511 ◽

Cited By ~ 2

Author(s):

Alexander Grote ◽

Susanne Schoch ◽

Albert J. Becker

Keyword(s):

Gene Regulation ◽

Temporal Lobe Epilepsy ◽

Human Brain ◽

Temporal Lobe ◽

Epigenetic Gene Regulation

Download Full-text

Development of temporal lobe epilepsy during maintenance electroconvulsive therapy: A case of human kindling?

Epilepsia Open ◽

10.1002/epi4.12294 ◽

2019 ◽

Vol 4 (1) ◽

pp. 200-205

Author(s):

Caroline Schotte ◽

Evy Cleeren ◽

Karolien Goffin ◽

Borbala Hunyadi ◽

Satya Buggenhout ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Electroconvulsive Therapy

Download Full-text

Catatonia following surgery for temporal lobe epilepsy successfully treated with electroconvulsive therapy

Epilepsy & Behavior ◽

10.1016/j.yebeh.2010.06.050 ◽

2010 ◽

Vol 19 (3) ◽

pp. 528-532 ◽

Cited By ~ 7

Author(s):

Daniel Maixner ◽

Oren Sagher ◽

Joshua Bess ◽

Jonathan Edwards

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Electroconvulsive Therapy

Download Full-text

Cannabidiol Acts at 5-HT1A Receptors in the Human Brain: Relevance for Treating Temporal Lobe Epilepsy

Frontiers in Behavioral Neuroscience ◽

10.3389/fnbeh.2020.611278 ◽

2020 ◽

Vol 14 ◽

Author(s):

Christopher Martínez-Aguirre ◽

Francia Carmona-Cruz ◽

Ana Luisa Velasco ◽

Francisco Velasco ◽

Gustavo Aguado-Carrillo ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Human Brain ◽

Temporal Lobe ◽

Cell Membranes ◽

Epileptic Seizures ◽

Mesial Temporal Lobe Epilepsy ◽

Pharmacological Interaction ◽

Protein Activation ◽

High Concentrations ◽

Temporal Neocortex

Experimental evidence indicates that cannabidiol (CBD) induces anxiolytic and antiepileptic effects through the activation of 5-HT1A receptors. These receptors are coupled to Gi/o proteins and induce inhibitory effects. At present, the interaction of CBD with 5-HT1A receptors in the human brain is unknown. The aim of this study focused on evaluating the interaction between CBD and 5-HT1A receptors in cell membranes obtained from the hippocampus and temporal neocortex of autopsies and patients with drug-resistant mesial temporal lobe epilepsy (DR-MTLE). Cell membranes were isolated from the hippocampus and temporal neocortex of a group of patients with DR-MTLE who were submitted to epilepsy surgery (n = 11) and from a group of autopsies (n = 11). The [3H]-8-OH-DPAT binding assay was used to determine the pharmacological interaction of CBD with 5-HT1A receptors. The [35S]-GTPγS assay was used to investigate the CBD-induced activation of Gi/o proteins through its action on 5-HT1A receptors.The CBD affinity (pKi) for 5-HT1A receptors was similar for autopsies and patients with DR-MTLE (hippocampus: 4.29 and 4.47, respectively; temporal neocortex: 4.67 and 4.74, respectively). Concerning the [35S]-GTPγS assay, no statistically significant changes were observed for both hippocampal and neocortical tissue (p > 0.05) at low CBD concentrations (1 pM to 10 μM). In contrast, at high concentrations (100 μM), CBD reduced the constitutive activity of Gi/o proteins of autopsies and DR-MTLE patients (hippocampus: 39.2% and 39.6%, respectively; temporal neocortex: 35.2% and 24.4%, respectively). These changes were partially reversed in the presence of WAY-100635, an antagonist of 5-HT1A receptors, in the autopsy group (hippocampus, 59.8%, p < 0.0001; temporal neocortex, 71.5%, p < 0.0001) and the group of patients with DR-MTLE (hippocampus, 53.7%, p < 0.0001; temporal neocortex, 68.5%, p < 0.001). Our results show that CBD interacts with human 5-HT1A receptors of the hippocampus and temporal neocortex. At low concentrations, the effect of CBD upon Gi/o protein activation is limited. However, at high concentrations, CBD acts as an inverse agonist of 5-HT1A receptors. This effect could modify neuronal excitation and epileptic seizures in patients with DR-MTLE.

Download Full-text