Investigation of Generalized EEG Paroxysms Accompanying Focal Epilepsies

2019 ◽  
Vol 50 (6) ◽  
pp. 413-422
Author(s):  
Arife Çimen Atalar ◽  
Ebru Nur Vanlı-Yavuz ◽  
Ebru Yılmaz ◽  
Nerses Bebek ◽  
Betül Baykan
Keyword(s):  
Focal Epilepsy ◽  
Hippocampal Sclerosis ◽  
Female Gender ◽  
Mesial Temporal Lobe Epilepsy ◽  
Control Group ◽  
Limited Information ◽  
Laboratory Findings ◽  
Parental Consanguinity ◽  
The Relationship ◽  
Eeg Features

Interictal focal EEG features were frequently observed in generalized, epilepsies, but there is limited information about interictal, epileptiform/nonepileptiform generalized paroxysms in focal epilepsies. We aimed to report the frequency and associated factors of generalized EEG discharges in focal epilepsy with unknown cause (FEUC) and mesial, temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). A total of 200 patients (FEUC in 90 patients; MTLE-HS in 110 patients) were included. Generalized epileptiform (spike/sharp waves simultaneously in all regions) and nonspecific generalized discharges (paroxysmal slow waves) were investigated. All clinical and laboratory findings of 2 groups were compared with each other and with remaining control group, without generalized paroxysms, statistically. Generalized EEG features were present in 22 (11%; 4 males) patients; 9 in the FEUC group (10%; 2) and 13 in the MTLE-HS group (11.8%). Female gender ( P < .021), febrile seizure ( P < .034), precipitant factors ( P < .025), and parental consanguinity ( P < .033) were significantly higher in the group with generalized EEG findings. Monotherapy rates were lower in the MTLE-HS group ( P < .05). The relationship of generalized EEG features with female gender and parental consanguinity may point out to a genetic property among focal epilepsies, while the relationship with febrile seizures and precipitant factors may be a clue about mechanisms with more extensive involvement of the neuronal networks.

scholarly journals Synaptic Reshaping and Neuronal Outcomes in the Temporal Lobe Epilepsy

2021 ◽  
Vol 22 (8) ◽  
pp. 3860
Author(s):  
Elisa Ren ◽  
Giulia Curia
Keyword(s):  
Animal Models ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Current Knowledge ◽  
Focal Epilepsy ◽  
Ex Vivo ◽  
Hippocampal Sclerosis ◽  
Control Group ◽  
Epileptogenic Zone ◽  
Epileptiform Discharges

Temporal lobe epilepsy (TLE) is one of the most common types of focal epilepsy, characterized by recurrent spontaneous seizures originating in the temporal lobe(s), with mesial TLE (mTLE) as the worst form of TLE, often associated with hippocampal sclerosis. Abnormal epileptiform discharges are the result, among others, of altered cell-to-cell communication in both chemical and electrical transmissions. Current knowledge about the neurobiology of TLE in human patients emerges from pathological studies of biopsy specimens isolated from the epileptogenic zone or, in a few more recent investigations, from living subjects using positron emission tomography (PET). To overcome limitations related to the use of human tissue, animal models are of great help as they allow the selection of homogeneous samples still presenting a more various scenario of the epileptic syndrome, the presence of a comparable control group, and the availability of a greater amount of tissue for in vitro/ex vivo investigations. This review provides an overview of the structural and functional alterations of synaptic connections in the brain of TLE/mTLE patients and animal models.

Dementia associated with epilepsy

2005 ◽  
Vol 17 (s1) ◽  
pp. S195-S206 ◽  
Author(s):  
Paulo Caramelli ◽  
Luiz Henrique Martins Castro
Keyword(s):  
Adverse Effects ◽  
Elderly Patients ◽  
Treatment Guidelines ◽  
Hippocampal Sclerosis ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Lobe ◽  
Impaired Cognition ◽  
Biological Abnormality ◽  
Available Information ◽  
The Relationship

In this review, we explore the relationship between epilepsy and cognition and between epilepsy and dementia. Chronic epilepsy, particularly mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis, may be associated with impaired cognition, which can be secondary to uncontrolled seizures, to adverse effects of antiepileptic drugs (AEDs) or to the underlying biological abnormality. The choice of an adequate AED with an appropriate dose regimen may lead to a favorable outcome. This feature is especially relevant in elderly patients with dementia and associated epilepsy, a vulnerable population in which the diagnosis of seizures can be difficult and for whom treatment guidelines are not yet available. Based on available information and on data derived from studies with other populations, recommendations for the management of these patients are presented.

How Different Are the Patients With Bilateral Hippocampal Sclerosis From the Unilateral Ones Clinically?

2016 ◽  
Vol 48 (3) ◽  
pp. 209-216 ◽  
Author(s):  
Ebru Nur Vanli-Yavuz ◽  
Betul Baykan ◽  
Serra Sencer ◽  
Altay Sencer ◽  
Isin Baral-Kulaksizoglu ◽  
...  
Keyword(s):  
Mental Retardation ◽  
Status Epilepticus ◽  
Epilepsy Surgery ◽  
Hippocampal Sclerosis ◽  
Control Group ◽  
High Signal ◽  
Binary Logistic Regression Analysis ◽  
Laboratory Findings ◽  
Patients With Epilepsy ◽  
Febrile Status Epilepticus

Purpose. There is a lack of knowledge on consecutive patients with epilepsy associated with bilateral hippocampal sclerosis (BHS). We aimed to investigate the differentiating features of BHS in comparison with unilateral HS (UHS). Method. We investigated our database for patients with epilepsy fulfilling the major magnetic resonance imaging criteria for BHS; namely, presence of bilateral atrophy and high signal changes on T2 and FLAIR series in the hippocampi. UHS patients seen in past 2 years were included as the control group. Clinical, EEG, and other laboratory findings, data on treatment response and epilepsy surgery were investigated from their files. Results. A total of 124 patients (31 with BHS and 93 with UHS; 49 right-sided and 44 left-sided) were included. We found that 16.1% of the BHS and 18.3% of the UHS groups were not drug-refractory. A binary logistic regression analysis performed with significant clinical features disclosed that history of febrile status epilepticus, mental retardation, and status epilepticus were statistically more common in BHS group. Moreover, diagnosis of psychosis established by an experienced psychiatrist and slowing of the EEG background activity were both found significantly more frequent in BHS. 66.67% of the operated BHS patients showed benefit from epilepsy surgery. Conclusions. BHS is a heterogeneous group, showing significant differences such as increased frequencies of mental retardation, status epilepticus, febrile status epilepticus and psychosis, in comparison to UHS. In all, 16.1% of the BHS cases showed a benign course similar to the UHS group and some patients with drug-resistant epilepsy may show benefit from epilepsy surgery.

scholarly journals The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Doori Kim ◽  
Seong-Gyu Ko ◽  
Eun-Kyoung Lee ◽  
Boyoung Jung
Keyword(s):  
Propensity Score ◽  
Temporomandibular Joint ◽  
Strong Association ◽  
Spinal Pain ◽  
Temporomandibular Joint Disorders ◽  
Medical Expenditure ◽  
Control Group ◽  
Limited Information ◽  
Number Of Visits ◽  
The Relationship

Abstract Background Patients with temporomandibular joint disorder (TMD) often complain of pain in other areas. Several studies have been conducted on spinal pain in TMD patients, but have contained only limited information. Therefore, this study analyzed the relationship between TMD and spinal pain in greater detail by using nationwide data. Methods A total of 12,375 TMD patients from the Korean National Health Insurance Review and Assessment database were analyzed. Controls were selected using propensity score-matching. The McNemar test, chi-square test, and paired t-test were used to compare the prevalence and severity of spinal pain between cases and matched controls. Logistic regression and linear regression models were used to analyze factors affecting the prevalence and severity of spinal pain in patients with TMD. Results The annual period prevalence of TMD was 1.1%. The prevalence was higher in younger individuals than in individuals of other ages and was higher in women than in men. The medical expenditure for TMD per person was $86. Among TMD patients, 2.5% underwent surgical procedures and 0.3% were hospitalized. The prevalence of spinal pain in patients with TMD was 48%, whereas that in the control group was 34%. Increased severity of TMD was associated with an increased probability of spinal pain. The medical expenditure, mean number of visits, and lengths of treatment for spinal pain were greater for patients with TMD than for controls ($136 vs. $81, 4.8 days vs. 2.7 days, 5.5 days vs. 3.3 days). Higher TMD grade was associated with greater differences in average medical expenditure, number of visits, and lengths of treatment for spinal pain between cases and controls. Additionally, for women, living in a rural area and having an older age and more severe TMD were associated with a greater probability of spinal pain and higher medical expenditure related to spinal pain. Conclusion A strong association was observed between the presence of TMD and the presence of spinal pain. The association became stronger as the severity of TMD increased, indicating a positive correlation between the severity of TMD and spinal pain.

scholarly journals The Relationship between Eating and Lifestyle Habits and Cancer in Van Lake Region: Another Endemic Region for Esophageal and Gastric Cancers

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Sebahattin Celik ◽  
E. Murat Yılmaz ◽  
Ferhat Özden ◽  
Cetin Kotan ◽  
Hayrettin Okut
Keyword(s):  
Patient Group ◽  
Eating Habits ◽  
Female Gender ◽  
Control Group ◽  
Endemic Region ◽  
Heavy Smoking ◽  
Gastric Cancers ◽  
Lake Region ◽  
Significant Difference ◽  
The Relationship

Purpose. To examine the relationship between esophageal and gastric cancers commonly seen in Van Lake region and the traditional eating habits of the geography.Materials and Methods. Esophageal and gastric cancer cases, who underwent surgery between January 1, 2012, and December 31, 2013, were examined. Pathology reports of the patients and presence ofHelicobacter pylori (HP)were recorded. Surveys were filled by face to face meeting or telephone call. Control group was created with randomly selected individuals without any cancer diagnosis having age, gender, and socioeconomic characteristics similar to patient group. All data were analyzed using SAS.9.3 statistical programme.Results. Compared with the control group, herby cheese consumption (a component of eating habits) and smoking were significantly higher in the patient group (P<0.001). Tandoor exposure is compared in terms of female gender, and significant difference was found between the groups (P=0.0013). As a result of the analysis with logistic regression more than 150 gr of herby cheese consumption per day was found to increase the cancer risk (odds ratio 1.017; 95% CI: 1.012–1.022).Conclusion. A high consumption of herby cheese, cooking bread on tandoor, and heavy smoking were seen to be important risk factors for esophageal and gastric cancers.

scholarly journals The subiculum and its role in focal epileptic disorders

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Maxime Lévesque ◽  
Massimo Avoli
Keyword(s):  
Focal Epilepsy ◽  
Drug Effects ◽  
Cell Loss ◽  
Mesial Temporal Lobe Epilepsy ◽  
Pathological Conditions ◽  
Epileptic Disorder ◽  
The Relationship ◽  
Limbic Area

AbstractThe subicular complex (hereafter referred as subiculum), which is reciprocally connected with the hippocampus and rhinal cortices, exerts a major control on hippocampal outputs. Over the last three decades, several studies have revealed that the subiculum plays a pivotal role in learning and memory but also in pathological conditions such as mesial temporal lobe epilepsy (MTLE). Indeed, subicular networks actively contribute to seizure generation and this structure is relatively spared from the cell loss encountered in this focal epileptic disorder. In this review, we will address: (i) the functional properties of subicular principal cells under normal and pathological conditions; (ii) the subiculum role in sustaining seizures in in vivo models of MTLE and in in vitro models of epileptiform synchronization; (iii) its presumptive role in human MTLE; and (iv) evidence underscoring the relationship between subiculum and antiepileptic drug effects. The studies reviewed here reinforce the view that the subiculum represents a limbic area with relevant, as yet unexplored, roles in focal epilepsy.

scholarly journals The Evaluation of Serum Endocan, ADAMTS-13 and P-Selectin Levels in Predicting Subclinical Atherosclerosis in Patients with Adrenal Incidentaloma

2021 ◽  
Author(s):  
Gulsum Gonulalan ◽  
Ummugulsum Can ◽  
Mehmet Akif Bor ◽  
Umut Gonulalan
Keyword(s):  
Subclinical Atherosclerosis ◽  
Adrenal Incidentaloma ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Dehydroepiandrosterone Sulfate ◽  
Control Group ◽  
Adrenocortical Adenoma ◽  
Laboratory Findings ◽  
Morning Cortisol ◽  
The Relationship

Objectives: To investigate the cardiometabolic risk factors as endocan, dehydroepiandrosterone sulfate (DHEAS), ADAMTS-13, p-selectin as a predictor of atherosclerosis in patients with non-functional adrenocortical adenoma (NFAI). Methods: We included 44 patients with NFAI and 44 healthy individuals as the control group. The demographic, laboratory findings and anthropometric measurements were evaluated. The levels of serum endocan, p-selectin, ADAMTS-13 and carotid intima-media thickness (CIMT) measurement were evaluated. Results: There was no difference between the control group and the patients with NFAI in terms of BMI, WC, systolic and diastolic blood pressure, HDL-C, ACTH, morning cortisol, ADAMTS-13 and p-selectin levels. However, the levels of waist-hip ratio, total cholesterol, insulin, HOMA-IR, LDL-C, CIMT, endocan were significantly higher in the NFAI group in comparison with the control group (p< 0.05). The levels of DHEAS were found significantly lower in the patients with NFAI (p<0.05). There was a positive correlation between ADAMTS-13, and endocan and p-selectin (r=0.436; p=0.003, r=0.414; p=0.005). Conclusions: This is the first study investigating the relationship between endocan, p-selectin, ADAMTS-13 levels and NFAI. Increased endocan levels and decreased DHEAS levels might be used as the indicators of atherosclerosis in patients with NFAI. CIMT was also found as an independent predictor for NFAI. Evaluation of cardiac and metabolic parameters is important in conservative treatment of patients with NFAI. Key Worlds: Adrenal Incidentaloma, Endocan, P-Selectin, ADAMTS-13

scholarly journals Early tissue damage and microstructural reorganization predict disease severity in experimental epilepsy

eLife ◽  
2017 ◽  
Vol 6 ◽  
Author(s):  
Philipp Janz ◽  
Niels Schwaderlapp ◽  
Katharina Heining ◽  
Ute Häussler ◽  
Jan G Korvink ◽  
...  
Keyword(s):  
Disease Severity ◽  
Focal Epilepsy ◽  
Hippocampal Sclerosis ◽  
Clinical Manifestations ◽  
Structural Mri ◽  
Mesial Temporal Lobe Epilepsy ◽  
Therapeutic Window ◽  
Curative Therapy ◽  
Tissue Reorganization ◽  
First Time

Mesial temporal lobe epilepsy (mTLE) is the most common focal epilepsy in adults and is often refractory to medication. So far, resection of the epileptogenic focus represents the only curative therapy. It is unknown whether pathological processes preceding epilepsy onset are indicators of later disease severity. Using longitudinal multi-modal MRI, we monitored hippocampal injury and tissue reorganization during epileptogenesis in a mouse mTLE model. The prognostic value of MRI biomarkers was assessed by retrospective correlations with pathological hallmarks Here, we show for the first time that the extent of early hippocampal neurodegeneration and progressive microstructural changes in the dentate gyrus translate to the severity of hippocampal sclerosis and seizure burden in chronic epilepsy. Moreover, we demonstrate that structural MRI biomarkers reflect the extent of sclerosis in human hippocampi. Our findings may allow an early prognosis of disease severity in mTLE before its first clinical manifestations, thus expanding the therapeutic window.

scholarly journals Optogenetic low-frequency stimulation of dentate granule cells prevents seizure generation in experimental epilepsy

2020 ◽  
Author(s):  
E Paschen ◽  
C Elgueta ◽  
K Heining ◽  
DM Vieira ◽  
C Orcinha ◽  
...  
Keyword(s):  
Seizure Control ◽  
Granule Cells ◽  
Focal Epilepsy ◽  
Hippocampal Sclerosis ◽  
Low Frequency ◽  
Mesial Temporal Lobe Epilepsy ◽  
Complete Suppression ◽  
Low Frequency Stimulation ◽  
Frequency Stimulation ◽  
Mesial Temporal Lobe

AbstractMesial temporal lobe epilepsy (MTLE) is the most common form of focal epilepsy in adults and is typically associated with hippocampal sclerosis and drug-resistant seizures. As an alternative to curative epilepsy surgery, brain stimulation evolves as a promising approach for seizure-interference. However, particularly in MTLE with severe hippocampal sclerosis, current stimulation protocols are often not effective. Here, we show that optogenetic low-frequency stimulation (oLFS) of entorhinal afferents exhibits unprecedented anti-ictogenic effects in chronically epileptic mice. Photostimulation at 1 Hz resulted in an almost complete suppression of focal seizures, independent of the degree of hippocampal sclerosis. Furthermore, by performing oLFS for 30 min before a pro-convulsive stimulus, seizure generalization was successfully prevented. Finally, acute slice experiments revealed a decreased excitability upon oLFS, which may partially explain the observed anti-epileptic effects. Taken together, our results suggest that oLFS of entorhinal afferents constitutes a promising approach for seizure control in MTLE.

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