scholarly journals Influence of Sleep and Sleep Deprivation on Ictal and Interictal Epileptiform Activity

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Antonio Díaz-Negrillo
Keyword(s):  
Sleep Deprivation ◽  
Epileptiform Activity ◽  
Epileptic Seizures ◽  
Future Research ◽  
Reciprocal Relation ◽  
Physiological Factors ◽  
Rigorous Approach ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
The Relationship

Sleep is probably one of the most important physiological factors implicated both in epileptic seizures and interictal epileptiform discharges. The neurophysiology concerning the relationship between sleep and epilepsy is well described in the literature; however, the pathological events that culminate in the seizures are poorly explored. The present paper intends to make a rigorous approach to the main mechanisms involved in this reciprocal relation. Knowledge of sleep and sleep deprivation effects in epilepsy stands as crucial in the understanding of how seizures are produced, their possible lines of treatment, and future research.

scholarly journals The relationship of sleep mechanisms and epileptogenesis

2020 ◽  
Vol 48 (1) ◽  
pp. 44-55
Author(s):  
A. B. Kozhokaru ◽  
P. N. Vlasov ◽  
A. S. Orlova
Keyword(s):  
Sleep Deprivation ◽  
Epileptiform Activity ◽  
Epileptic Seizures ◽  
Epileptiform Discharge ◽  
Sleep Structure ◽  
Pathophysiological Mechanisms ◽  
Epileptic Syndrome ◽  
The Common ◽  
Relationship Of ◽  
The Relationship

Close links between epilepsy and sleep is doubtless; however, the available literature does not allow for its unequivocal interpretation from the common pathophysiological mechanisms' perspective. GABAergic neuronal deficiency is believed to be the neurochemical background of the intimate mechanisms of sleep and epileptogenesis. Sleep impacts the epileptiform activity, with an increase in epileptiform discharge during NREM and a decrease during REM phases. Sleep deprivation may complicate the course of epilepsy, while epileptic attacks may change the sleep structure and quality. Anti-epileptic agents exert diverse effects on the sleep architectonics; they can induce sedation or increase alertness. Our potential to correct the results of the pathological interplay between sleep mechanisms and epilepsy are rather limited and are frequently overestimated by clinicians. Investigation of the interrelationship between epileptic seizures and sleep and the use of polysomnography can substantially add to the diagnosis of the epileptic syndrome and define the subsequent outcomes.

scholarly journals Nonepileptic seizures: an updated review

CNS Spectrums ◽  
2016 ◽  
Vol 21 (3) ◽  
pp. 239-246 ◽  
Author(s):  
David L. Perez ◽  
W. Curt LaFrance
Keyword(s):  
Behavioral Therapy ◽  
Epileptiform Activity ◽  
Epileptic Seizures ◽  
Clinical History ◽  
Conversion Disorder ◽  
Future Research ◽  
Treatment Interventions ◽  
Diagnostic Certainty ◽  
Typical Event ◽  
Nonepileptic Seizures

Psychogenic nonepileptic seizures (PNES) are a functional neurological disorder/conversion disorder subtype, which are neurobehavioral conditions at the interface of neurology and psychiatry. Significant advancements over the past decade have been made in the diagnosis, management, and neurobiological understanding of PNES. This article reviews published PNES research focusing on semiologic features that distinguish PNES from epileptic seizures, consensus diagnostic criteria, the intersection of PNES and other comorbidities, neurobiological studies, evidence-based treatment interventions, and outcome studies. Epidemiology and healthcare utilization studies highlight a continued unmet medical need in the comprehensive care of PNES. Consensus guidelines for diagnostic certainty are based on clinical history, semiology of witnessed typical event(s), and EEG findings. While certain semiologic features may aid in the diagnosis of PNES, the gold standard remains capturing a typical event on video electroencephalography (EEG) showing the absence of epileptiform activity with history and semiology consistent with PNES. Medical-neurologic and psychiatric comorbidities are prevalent in PNES; these should be assessed in diagnostic evaluations and integrated into treatment interventions and prognostic considerations. Several studies, including a pilot, multicenter, randomized clinical trial, have now demonstrated that a cognitive behavioral therapy–informed psychotherapy is an efficacious treatment for PNES, and additional efforts are necessary to evaluate the utility of pharmacologic and other psychotherapy treatments. Neuroimaging studies, while requiring replication, suggest that PNES may occur in the context of alterations within and across sensorimotor, emotion regulation/processing, cognitive control, and multimodal integration brain systems. Future research could investigate similarities and differences between PNES and other somatic symptom disorders.

Dynamic Statistical Parametric Mapping for Analyzing the Magnetoencephalographic Epileptiform Activity in Patients With Epilepsy

2004 ◽  
Vol 19 (3) ◽  
pp. 363-369
Author(s):  
Hideaki Shiraishi ◽  
Steven M. Stufflebeam ◽  
Susanne Knake ◽  
Seppo P. Ahlfors ◽  
Akira Sudo ◽  
...  
Keyword(s):  
Focal Cortical Dysplasia ◽  
Epileptiform Activity ◽  
Rapid Change ◽  
Statistical Parametric Mapping ◽  
Cortical Dysplasia ◽  
Parametric Mapping ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
L2 Norm ◽  
Patients With Epilepsy

Our current purpose is to evaluate the applicability of dynamic statistical parametric mapping, a novel method for localizing epileptiform activity recorded with magnetoencephalography in patients with epilepsy. We report four pediatric patients with focal epilepsies. Magnetoencephalographic data were collected with a 306-channel whole-head helmet-shaped sensor array. We calculated equivalent current dipoles and dynamic statistical parametric mapping movies of the interictal epileptiform discharges that were based in the minimum-L2 norm estimate, minimizing the square sum of the dipole element amplitudes. The dynamic statistical parametric mapping analysis of interictal epileptiform discharges can demonstrate the rapid change and propagation of interical epileptiform discharges. According to these findings, specific epileptogenic lesion—focal cortical dysplasia could be found and patients could be operated on successfully. The presurgical analysis of interictal epileptiform discharges using dynamic statistical parametric mapping seems to be promising in patients with a possible underlying focal cortical dysplasia and might help to guide the placement of invasive electrodes. ( J Child Neurol 2005;20:363—369).

Electroencephalography Patterns and Prognosis in Acute Ischemic Stroke

2017 ◽  
Vol 44 (3-4) ◽  
pp. 128-134 ◽  
Author(s):  
Fabricio O. Lima ◽  
João A.G. Ricardo ◽  
Ana C. Coan ◽  
Diogo C. Soriano ◽  
Wagner M. Avelar ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Epileptiform Activity ◽  
Prognostic Significance ◽  
Multivariable Analysis ◽  
Periodic Patterns ◽  
Medication Therapy ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
History Of

Background and Purpose: The prognostic significance of interictal epileptiform discharges (IED) and periodic patterns (PP) after ischemic stroke has not been assessed. We sought to test whether IED and PP, detected on standard Electroencephalography (EEG) performed during the acute phase of ischemic stroke are associated with a worse functional outcome. Methods: One-hundred-fifty-seven patients 18 years or older with a diagnosis of acute ischemic stroke presenting within 72 h from stroke onset were prospectively enrolled and followed. Patients with a pre-stroke history of seizures or epilepsy, previous debilitating neurological disease or conditions that precluded the performance of EEG were excluded. Interpretation was performed by a blinded board certified neurophysiologist. IED and PP (grouped as epileptiform activity [EA]) were defined according to proposed guidelines. Univariable and multivariable analyses were used to identify predictors of outcome (modified Rankin Scale dichotomized ≤2 vs. ≥3) at 3 months. Results: In the univariable analysis, admission NIHSS (OR 1.20, 95% CI 1.12-1.28, p = 0.001), age (OR 1.03, 95% CI 1.01-1.05, p = 0.02), and presence of EA (OR 2.94, 95% CI 1.51-5.88, p = 0.001) were significantly associated with the outcome at 3 months. In the multivariable analysis, only admission NIHSS (OR 1.19, 95% CI 1.11-1.28, p < 0.001) and the presence of EA (OR 2.27, 95% CI 1.04-5.00, p = 0.04) were independently associated with the prognosis. Significance: The importance of EEG in the prognosis of acute ischemic stroke warrants additional research, examining the role of medication therapy on the outcome and the occurrence of seizures for those patients with specific EEG patterns.

scholarly journals Spontaneous EEG-Functional MRI in Mesial Temporal Lobe Epilepsy: Implications for the Neural Correlates of Consciousness

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Zheng Wang ◽  
Loretta Norton ◽  
R. Matthew Hutchison ◽  
John R. Ives ◽  
Seyed M. Mirsattari
Keyword(s):  
Temporal Lobe ◽  
Animal Studies ◽  
Brain Activity ◽  
Epileptic Seizures ◽  
Mesial Temporal Lobe Epilepsy ◽  
Unified Framework ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Mesial Temporal Lobe ◽  
Hemodynamic Processes

The combination of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) has been shown to have great potential for providing a greater understanding of normal and diseased states in both human and animal studies. Simultaneous EEG-fMRI is particularly well suited for the study of epilepsy in that it may reveal the neurobiology of ictal and interictal epileptiform discharges and noninvasively localize epileptogenic foci. Spontaneous, coherent fluctuations of neuronal activity and the coupled hemodynamic responses have also been shown to provide diagnostic markers of disease, extending our understanding of intrinsically structured ongoing brain activity. Following a short summary of the hardware and software development of simultaneous EEG-fMRI, this paper reviews a unified framework of integrating neuronal and hemodynamic processes during epileptic seizures and discusses the role and impact of spontaneous activity in the mesial temporal lobe epilepsies with particular emphasis on the neural and physiological correlates of consciousness.

scholarly journals Musical components important for the Mozart K448 effect in epilepsy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Robert J. Quon ◽  
Michael A. Casey ◽  
Edward J. Camp ◽  
Stephen Meisenhelter ◽  
Sarah A. Steimel ◽  
...  
Keyword(s):  
Refractory Epilepsy ◽  
Focal Epilepsy ◽  
Epileptiform Activity ◽  
Brain Regions ◽  
Original Version ◽  
Pharmacological Intervention ◽  
Theta Power ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Insight Into

AbstractThere is growing evidence for the efficacy of music, specifically Mozart’s Sonata for Two Pianos in D Major (K448), at reducing ictal and interictal epileptiform activity. Nonetheless, little is known about the mechanism underlying this beneficial “Mozart K448 effect” for persons with epilepsy. Here, we measured the influence that K448 had on intracranial interictal epileptiform discharges (IEDs) in sixteen subjects undergoing intracranial monitoring for refractory focal epilepsy. We found reduced IEDs during the original version of K448 after at least 30-s of exposure. Nonsignificant IED rate reductions were witnessed in all brain regions apart from the bilateral frontal cortices, where we observed increased frontal theta power during transitions from prolonged musical segments. All other presented musical stimuli were associated with nonsignificant IED alterations. These results suggest that the “Mozart K448 effect” is dependent on the duration of exposure and may preferentially modulate activity in frontal emotional networks, providing insight into the mechanism underlying this response. Our findings encourage the continued evaluation of Mozart’s K448 as a noninvasive, non-pharmacological intervention for refractory epilepsy.

scholarly journals Interictal Epileptiform Discharge Dynamics in Peri-sylvian Polymicrogyria Using EEG-fMRI

2021 ◽  
Vol 12 ◽  
Author(s):  
Noa Cohen ◽  
Yoram Ebrahimi ◽  
Mordekhay Medvedovsky ◽  
Guy Gurevitch ◽  
Orna Aizenstein ◽  
...  
Keyword(s):  
Case Series ◽  
Epileptic Seizures ◽  
Epileptic Activity ◽  
Scalp Eeg ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Malformation Of Cortical Development ◽  
Interictal Epileptiform Discharge ◽  
Drug Resistant Epilepsy ◽  
Patients With Epilepsy

Polymicrogyria (PMG) is a common malformation of cortical development associated with a higher susceptibility to epileptic seizures. Seizures secondary to PMG are characterized by difficult-to-localize cerebral sources due to the complex and widespread lesion structure. Tracing the dynamics of interictal epileptiform discharges (IEDs) in patients with epilepsy has been shown to reveal the location of epileptic activity sources, crucial for successful treatment in cases of focal drug-resistant epilepsy. In this case series IED dynamics were evaluated with simultaneous EEG-fMRI recordings in four patients with unilateral peri-sylvian polymicrogyria (PSPMG) by tracking BOLD activations over time: before, during and following IED appearance on scalp EEG. In all cases, focal BOLD activations within the lesion itself preceded the activity associated with the time of IED appearance on EEG, which showed stronger and more widespread activations. We therefore propose that early hemodynamic activity corresponding to IEDs may hold important localizing information potentially leading to the cerebral sources of epileptic activity. IEDs are suggested to develop within a small area in the PSPMG lesion with structural properties obscuring the appearance of their electric field on the scalp and only later engage widespread structures which allow the production of large currents which are recognized as IEDs on EEG.

Value of the Early Electroencephalogram after a First Unprovoked Seizure

2003 ◽  
Vol 34 (3) ◽  
pp. 140-144 ◽  
Author(s):  
A. Schreiner ◽  
B. Pohlmann-Eden
Keyword(s):  
Sleep Deprivation ◽  
Risk Ratio ◽  
Predictive Value ◽  
Epileptiform Activity ◽  
Adult Patients ◽  
Seizure Recurrence ◽  
Unprovoked Seizure ◽  
Epileptiform Discharges ◽  
Increased Risk ◽  
Recurrence Risk Ratio

Studies on the predictive value of the electroencephalogram (EEG) concerning the risk of seizure recurrence have shown contradictory results. We prospectively studied the predictive value of the standard EEG and EEG with sleep deprivation for seizure relapse in adult patients presenting with a first unprovoked seizure. EEGs were performed on 157 adult patients within the first 48 hours of the first seizure. Additional EEGs with sleep deprivation were obtained in 60 cases. The standard EEG was abnormal in 70.7% and significantly associated with an increased risk of seizure recurrence [risk ratio 4.5, 95% confidence interval (CI) 1.8; 11.3, p=0.001]. Subgroup analysis revealed the highest recurrence rates for patients with focal epileptiform activity (risk ratio 2.2, CI 1.2; 4.2, p=0.01). EEGs with sleep deprivation were abnormal in 48.3% of all cases and revealed epileptiform discharges in 13.3% of the patients who had no epileptiform activity in the standard EEG. Routine EEG revealed abnormalities in 60 of 94 patients who presented with normal neurologic status on admission. Further neuroradiological examinations detected previously unknown brain lesions in 19 of these cases, particularly cerebrovascular disease (CVD, n=7), brain tumors (n=6), and posttraumatic scars (n=4). In conclusion, the EEG is important for the early detection of focal nonepileptic and epileptic abnormalities after a first unprovoked seizure in adult patients and may provide valuable information on previously unknown disorders, particularly CVD and cerebral tumors. The abnormal EEG is a highly significant predictor for seizure recurrence. An additional EEG with sleep deprivation is helpful in cases when standard EEG does not reveal epileptiform discharges.

Fluorometric Monitoring of NADH Levels in Cerebral Cortex

Neurosurgery ◽  
1978 ◽  
Vol 2 (2) ◽  
pp. 114-121 ◽  
Author(s):  
J.M. Van Buren ◽  
D.V. Lewis ◽  
W.H. Schuette ◽  
W.C. Whitehouse ◽  
C. Ajmone Marsan
Keyword(s):  
Cerebral Cortex ◽  
Nicotinamide Adenine Dinucleotide ◽  
Epileptiform Activity ◽  
Low Frequency ◽  
Cortical Stimulation ◽  
Pathological Examination ◽  
Experimental Conditions ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Cortical Electrical Activity

Abstract In 14 patients operated upon for focal cerebral seizures under local anesthesia, cortical electrical activity was compared with the levels of nicotinamide adenine dinucleotide (NADH) observed fluorometrically. NADH levels fell 3 to 15% in response to 5-second intervals of cortical stimulation in 42 of 70 observations. Although a rough correlation was seen between the quantity of current delivered (milliamperes × seconds) and the NADH decrease, this varied from case to case. The presence of cortical afterdischarge often, but not invariably, corresponded to a greater percentage of change in the NADH levels. Averaging the NADH response to sporadic interictal epileptiform discharges failed to demonstrate concomitant NADH reductions. A similar lack of change was seen in four patients in whom low frequency spike foci were induced by topically applied penicillin in cortex destined for excision. Preliminary studies of the topography of spread of NADH change after cortical stimulation indicate that this is usually asymmetrical in human epileptogenic cortex. Under experimental conditions in cats, it seemed possible to differentiate primary from projected epileptiform activity, in that the projected activity had little or no concomitant fall in the NADH level after the electrographic spike. Pathological examination of the excised sites of NADH recording showed, with one exception, fibrous astrocytic transformation of the central cortex layers.

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