Convulsive Episodes Research Articles

Acceptability – a neglected dimension of access to health care: findings from a study on childhood convulsions in rural Tanzania

BackgroundAcceptability is a poorly conceptualized dimension of access to health care. Using a study on childhood convulsion in rural Tanzania, we examined social acceptability from a user perspective. The study design is based on the premise that a match between health providers’ and clients’ understanding of disease is an important dimension of social acceptability, especially in trans-cultural communication, for example if childhood convulsions are not linked with malaria and local treatment practices are mostly preferred. The study was linked to health interventions with the objective of bridging the gap between local and biomedical understanding of convulsions.MethodsThe study combined classical ethnography with the cultural epidemiology approach using EMIC (Explanatory Model Interview Catalogue) tool. EMIC interviews were conducted in a 2007/08 convulsion study (n = 88) and results were compared with those of an earlier 2004/06 convulsion study (n = 135). Earlier studies on convulsion in the area were also examined to explore longer-term changes in treatment practices.ResultsThe match between local and biomedical understanding of convulsions was already high in the 2004/06 study. Specific improvements were noted in form of (1) 46% point increase among those who reported use of mosquito nets to prevent convulsion (2) 13% point decrease among caregivers who associated convulsion with ‘evil eye and sorcery’, 3) 14% point increase in prompt use of health facility and 4)16% point decrease among those who did not use health facility at all. Such changes can be partly attributed to interventions which explicitly aimed at increasing the match between local and biomedical understanding of malaria. Caregivers, mostly mothers, did not seek advice on where to take an ill child. This indicates that treatment at health facility has become socially acceptable for severe febrile with convulsion.ConclusionAs an important dimension of access to health care ‘social acceptability’ seems relevant in studying illnesses that are perceived not to belong to the biomedical field, specifically in trans-cultural societies. Understanding the match between local and biomedical understanding of disease is fundamental to ensure acceptability of health care services, successful control and management of health problems. Our study noted some positive changes in community knowledge and management of convulsion episodes, changes which might be accredited to extensive health education campaigns in the study area. On the other hand it is difficult to make inference out of the findings as a result of small sample size involved. In return, it is clear that well ingrained traditional beliefs can be modified with communication campaigns, provided that this change resonates with the beneficiaries.

Kliniczna i laboratoryjna charakterystyka infekcji rotawirusowych u dzieci

IntroductionRotavirus infections are the major cause of gastroenteritis, frequently lead to hospitalization, and even death of children around the world. AimAnalysis of the clinical image of rotavirus infections in children and determination of the kind and frequency of systemic complications which result from them. Material and MethodsFrom among 176 patients hospitalized due to dehydrations during gastroenteritis, children with rotavirus etiology infections, diagnosed basing on stools samples tests, were separated. Patients were divided into 3 age subgroups, their clinical image and the frequency of complications were examined. ResultsRotavirus infections were diagnosed in 87 patients (49%), in the average age of 39.66 months, most frequently in boys (52.87%). In the clinical image predominated watery diarrhea (93%), vomiting (85%), and fever (43%). The average duration of the children's hospitalization was 6 days. Complications developed in 26 children (29.89%), including: an increase of aminotransferase activity in 13, pneumonia in 7, and neurological complications in 6 children. In 4 patients single episodes of convulsions were observed, in 2 children rotavirus neuroinfections were diagnosed. One child required treatment in an intensive care unit. In one patient after rotavirus infection neurological complications are still observed. More frequent occurrence of complications in the subgroup of the youngest and chronically ill children was noted. ConclusionsDuring rotavirus infections great number of organ complications may appear, including the especially dangerous for health and life neuroinfections. Therefore, common use of rotavirus vaccinations is very important for children health.

Risk factors associated with postoperative seizures in patients undergoing cardiac surgery who received tranexamic acid: A case-control study

Antifibrinolytic agents are used during cardiac surgery to minimize bleeding and reduce exposure to blood products. Several reports suggest that tranexamic acid (TA) can induce seizure activity in the postoperative period. To examine factors associated with postoperative seizures in patients undergoing cardiac surgery who received TA. University-affiliated hospital. Case-control study. Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) between January 2008 and December 2009 were identified. During this time, all patients undergoing heart surgery with CPB received TA. Cases were defined as patients who developed seizures that required initiation of anticonvulsive therapy within 48 h of surgery. Exclusion criteria included subjects with preexisting epilepsy and patients in whom the convulsive episode was secondary to a new ischemic lesion on brain imaging. Controls who did not develop seizures were randomly selected from the initial cohort. From an initial cohort of 903 patients, we identified 32 patients with postoperative seizures. Four patients were excluded. Twenty-eight cases and 112 controls were analyzed. Cases were more likely to have a history of renal impairment and higher preoperative creatinine values compared with controls (1.39 ± 1.1 vs. 0.98 ± 0.02 mg/dL, P = 0.02). Significant differences in the intensive care unit, postoperative and total lengths of stay were observed. An association between high preoperative creatinine value and postoperative seizure was identified. TA may be associated with the development of postoperative seizures in patients with renal dysfunction. Doses of TA should be reduced or even avoided in this population.

Primary Cerebral Nocardiosis in a Renal Transplant Recipient: A Case Report

Nocardial brain abscess is a rare central nervous system infection. A 50 year old renal transplant recipient developed a nocardial cerebral abscess. It manifested clinically with pyrexia of unknown origin, recurrent episodes of convulsions and a right sided hemiparesis. The purulent material was drained and sent to the Microbiology Laboratory for culture and sensitivity studies. Direct microscopy and culture confirmed the diagnosis of nocardial infection.

Orofacial injuries associated with eclampsia in patients presenting at a Nigerian Tertiary Hospital

A prospective study was conducted to determine the incidence and pattern of orofacial injuries among eclamptic patients at the Lagos State University Teaching Hospital between December 2008 and November 2009. The incidence of orofacial injuries was 42%. Most injuries were due to bite and forceful insertion of hard objects into the patient's mouth by relatives during convulsive episodes. The type of antenatal care received had an influence on the incidence of orofacial injuries and there was a correlation between the number of convulsions and orofacial injuries. The mortality rate from eclampsia was 20.6%, and presence of orofacial injuries was a risk factor for mortality. Obstetricians and other healthcare providers should be familiar with the ways of preventing these injuries and seek early maxillofacial consultation when they occur. There is need for community education on the dangers of forceful insertion of hard objects into the mouth of eclamptics during fits.

Dual protective effect of Passiflora incarnata in epilepsy and associated post-ictal depression

Ethnopharmacological relevancePassiflora incarnata L. (Passifloraceae) has been used for the treatment of epilepsy in several traditional systems of medicine. Aim of the studyThe aerial parts of Passiflora incarnata contain multiple bioactive metabolites such as, flavonoids (like, chrysin that show CNS depressant activity by agonizing GABA–benzodiazepine receptor), amino acids (like, GABA), harmala alkaloids (reversible monoamine oxidase-A inhibitor), etc. In view of this, the present study was designed to investigate dual protective effect of the hydroethanolic extract of Passiflora incarnata in pentylenetetrazol (PTZ)-induced seizure and associated post-ictal depression. Materials and methodsDifferent groups of mice were administered with repeated subconvulsive doses of PTZ (50mg/kg; i.p.) at an interval of 5 days for 15 days. From 5th to 15th day the animals in different groups were administered daily with varying doses of hydroethanolic extract of Passiflora incarnata (150, 300, and 600mg/kg; i.p.), diazepam (2mg/kg; i.p.) and vehicle. On every 5th day, after PTZ treatment, seizure severity (score) was noted. Following convulsive episodes the locomotor activity (using actophotometer) and immobility period (using forced swim test) were also determined. On 15th day after behavioral assessment, the brain serotonin and noradrenaline levels were determined using spectrofluorometric methods. ResultsTreatment with the extract significantly (p<0.05) reduced the seizure severity and immobility period as compared to vehicle control, in a dose and time-dependent manner. Moreover, the extract treatment retained the serotonin and noradrenaline levels of the brain. ConclusionsThe results of present study concluded that the hydroethanolic extract of Passiflora incarnata suppress PTZ-induced seizures, and ameliorates its associated post-ictal depression, which has been found to be get worsened with the standard antiepileptic drug, diazepam.

Risk of convulsions in children after monovalent H1N1 (2009) and trivalent influenza vaccines: A database study

The monovalent H1N1 (2009) pandemic influenza vaccine used predominantly in the UK in 2009/10 was a split virion vaccine with a novel oil-in-water adjuvant (ASO3). While this was highly immunogenic it was also reactogenic especially for fever in children. There is a paucity of comparative data on reactogenicity of trivalent influenza vaccine (TIV). Using the General Practice Research Database (GPRD) we investigated whether there was an increased risk of convulsions in children vaccinated with monovalent H1N1 influenza vaccine in the 2009/10 season and also the risk after vaccination with the seasonal TIVs using the self-controlled case-series method. A total of 2366 children aged under 10 years with at least one convulsion recorded in the GPRD and who had received at least one influenza vaccine at anytime (2858 doses of TIV and 1895 doses of the monovalent H1N1 influenza vaccine) were identified between May 2000 and April 2010. Over this period these 2366 children had a total of 3846 convulsion episodes. There was no increase in the incidence rate ratio (IRR) in the week after vaccination for either the monovalent H1N1 influenza vaccine (IRR 0.99, 95% CI 0.61-1.60) or the first dose of TIV (IRR 0.89, 95% CI 0.53-1.52). A signal of an elevated risk in the first few days after the second dose of monovalent H1N1 influenza vaccine was seen with an IRR for days 1-3 post vaccination of 3.48 (95% CI 0.86-14.07). This is consistent with findings of increased fever in a clinical trial. These results neither provide evidence of an increased risk of convulsions following TIV over a 10-year surveillance period nor following a single dose of the ASO3 adjuvanted monovalent H1N1 vaccine in 2009/10.

Clinical Presentation of Febrile Convulsions in Benin City

Febrile convulsions are caused by fever due to infection soccuring outside the Central Nervous System and are recognised as major contributors to morbidity and mortality in children 6months to 60 months of age in developing countries. This study is designed to determine its prevalence in children, with a view to documenting its key clinicall features at presentation. Records at Modic Medical Centre show 2291 children were hospitalized between January 1st and Decemeber 31st 2009. Over this period 159(5.4%) children were treated for febrile convulsions. Although febrile convulsion is common in children less than 60 months of age, it is more frequent in those less than 24 months of age accounting for 64(40.3%) with overall male to female ratio of 1.6:1. First episodes of febrile convulsions were recorded in 73% of children, while a strong family history was noted in 35%. Its commonest mode presentation was simple febrile seizures (46.5%), followed by complex febrile (32.1%) and prolonged seizures (21.4%). In addition, the use of unorthodox interventions before hospital attendance was found to be common. This study therefore concludes that febrile convulsion is a common childhood disorder in Benin City and eviron with a prevalence rate of 5.4%. It is that recognising its associated risk factors will lead to appropriate interventions and decrease in its prevalence in Benin City and environs. It is reccommended that unorthodox pre-hospital practices should be stopped completely to avoid its complications and adverse outcome.Keywords: Fever, children, Benin City

Dengue Shock Syndrome with Two Atypical Complications

The authors present 2 cases of dengue shock syndrome with unusual complications. In the first case, a 14-y-old boy with dengue shock syndrome who required aggressive fluid resuscitation, developed abdominal compartment syndrome (ACS). Patient developed severe shock, increased ventilator requirement and oliguria as a consequence of ACS. Patient responded well to abdominal paracentesis draining 2.7 l of fluid and made rapid recovery. In the second case, 8-y-old girl was treated for dengue shock syndrome, including mechanical ventilation for ARDS. In the second wk of illness, she developed severe neurological manifestations including frequent episodes of convulsions, hallucinations and altered sensorium. She was diagnosed to have acute demyelinating encephalomyelitis from CT brain findings. She responded well to pulse steroid therapy with complete neurological recovery.

The role of the glutathione system in seizures induced by diphenyl diselenide in rat pups

The present study investigated the role of the glutathione system in seizures induced by diphenyl diselenide (PhSe)2 (50mg/kg) in rat pups (post natal day, 12–14). Reduced glutathione (GSH) (300nmol/site; i.c.v.), administered 20min before (PhSe)2, abolished the appearance of seizures, protected against the inhibition of catalase and δ-aminolevulinic dehydratase (δ-ALA-D) activities and increased glutathione peroxidase (GPx) activity induced by (PhSe)2. Administration of l-buthionine sulfoximine (BSO, a GSH-depleting compound) (3.2μmol/site; i.c.v.) 24h before (PhSe)2 increased the percentage (42–100%) of rat pups which had seizure episodes, reduced the onset for the first convulsive episode. In addition, BSO increased thiobarbituric acid reactive species (TBARS) levels and decreased GSH content, catalase, δ-ALA-D and Na+, K+-ATPase activities. Treatment with sub effective doses of GSH (10nmol/site) and d-2-amino-7-phosphonoheptanoic acid (AP-7, an antagonist of the glutamate site at the NMDA receptor; 5mg/kg, i.p.) abolished the appearance of seizures induced by (PhSe)2 in rat pups. Sub effective doses of GSH and kynurenic acid (an antagonist of strychnine-insensitive glycine site at the NMDA receptor; 40mg/kg, i.p.) were also able in abolishing the appearance of seizures induced by (PhSe)2. In conclusion, administration of GSH protected against seizure episodes induced by (PhSe)2 in rat pups by reducing oxidative stress and, at least in part, by acting as an antagonist of glutamate and glycine modulatory sites in the NMDA receptor.

Spinal anesthesia for lower segment Cesarean section in patients with stable eclampsia

Study Objective To report the use of spinal anesthesia in stable eclamptic patients. Design Prospective case series. Setting Emergency operating room of a metropolitan hospital. Patients 12 “stable” eclamptic parturients. Interventions Subarachnoid block was instituted with hyperbaric 0.5% bupivacaine 1.7 mL with fentanyl 25 μg. Measurements Intraoperative maternal hypotension, episodes of convulsion, the need to convert to general anesthesia, and Apgar scores at 1 and 5 minutes were recorded. Main Results Only one of the 12 parturients had an episode of hypotension (treated by intravenous ephedrine), while no patient had a convulsion over the 48 hours after delivery. The sensory level achieved was T 5-T 6 and none of the cases was converted to general anesthesia. Median Apgar scores at 1 and 5 minutes were 8 and 9, respectively. Conclusion Spinal anesthesia avoided the known risks of general anesthesia and was not associated with any major complications.

Orofacial and dental injuries associated with seizures in paediatric patients in Lagos University Teaching Hospital

Objective To determine the prevalence and pattern of presentation of orofacial and dental injuries in children with seizures at the Children's Emergency Unit of the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. Methods This was a prospective study of children with febrile or non-febrile convulsion who presented at the Children's Emergency Unit of LUTH between July 2008 and August 2009. The age, gender, type of convulsion and the presence/absence of orofacial and other bodily injuries were recorded in a proforma. Mechanism, type and classification of injury were recorded for patients with orofacial injuries. Results A total of 257 children (148 males and 109 females) with febrile/non-febrile convulsion were included in the analysis. The mean age (SD) of patients was 32.8 ± 40.5 months. There were 223 (86.8%) cases of febrile convulsion and 34 (13.3%) cases of non-febrile convulsion. Thirteen children sustained orofacial injuries giving a prevalence of 5.1%. There was no significant difference in the prevalence of orofacial injury between patients with febrile convulsion (4.5%) and those with non-febrile convulsion (8.8%) ( P = 0.282). The most common cause of orofacial injuries was forceful insertion of hard object into the mouth during convulsive episodes. Twelve (92.3%) patients sustained soft tissue injury, while one sustained both soft and hard tissue injuries. The most common site of injury was the lip. Conclusions Oro-facial and dental injuries may occur in children with seizures. It is therefore important that these injuries be looked for by the paediatrician and the dentist/oral and maxillofacial surgeons should be involved in managing these children.

Nucleoside triphosphate diphosphohydrolases role in the pathophysiology of cognitive impairment induced by seizure in early age

Studies have shown that seizures in young animals lead to later cognitive deficits. There is evidence that long-term potentiation (LTP) and long-term depression (LTD) might contribute to the neural basis for learning and memory mechanism and might be modulated by ATP and/or its dephosphorylated product adenosine produced by a cascade of cell-surface transmembrane enzymes, such as E-NTPDases (ecto-nucleoside triphosphate diphosphohydrolases) and ecto-5′-nucleotidase. Thus, we have investigated if hippocampal ecto-nucleotidase activities are altered at different time periods after one episode of seizure induced by kainic acid (KA) in 7 days old rats. We also have evaluated if 90 day-old rats previously submitted to seizure induced by KA at 7 days of age presented cognitive impairment in Y-maze behavior task. Our results have shown memory impairment of adult rats (Postnatal day 90) previously submitted to one single seizure episode in neonatal period (Postnatal day 7), which is accompanied by an increased ATP hydrolysis in hippocampal synaptosomes. The metabolism of ATP evaluated by HPLC confirmed that ATP hydrolysis was faster in adult rats treated with KA in neonatal period than in controls. Surprisingly, the mRNA and protein levels as seen by PCR and Western blot, respectively, were not altered by the KA administration in early age. Since we have found an augmented hydrolysis of ATP and this nucleotide seems to be important to LTP induction, we could assume that impairment of memory and learning observed in adult rats which have experienced a convulsive episode in postnatal period may be a consequence of the increased ATP hydrolysis. These findings correlate the purinergic signaling to the cognitive deficits induced by neonatal seizures and contribute to a better understanding about the mechanisms of seizure-induced memory dysfunction.

Adverse events following pandemic influenza vaccine Pandemrix ® reported in the French military forces—2009–2010

Background In the face of the A(H1N1) 2009 influenza pandemic, in October 2009 the French military health service (SSA) initiated a large vaccination campaign with Pandemrix ® vaccine in the military forces. The aim of this study was to describe vaccine adverse events (VAE) reported during this campaign. Methods VAE and the number of people vaccinated were surveyed by the SSA Epidemiological network across all military forces during the campaign, from October 2009 to April 2010. For each case, a notification form was completed, providing patient and clinical information. Three types of VAE were considered: non-serious, serious and unexpected. Results There were 315.4 reported VAE per 100,000 vaccinations. Vaccination and VAE incidence rate peaks coincided with influenza epidemic peak in early December. The number of injected doses was 49,138, corresponding to a 14.5% vaccination coverage among military personnel, and 155 VAE were reported, including 5 serious VAE (1 Guillain-Barre syndrome, 2 malaises and 1 convulsive episode). Most VAE were non-serious (97.1%). Among these, 6 cases of local, rapidly regressive paresthesia were observed. Discussion The military VAE surveillance system constitutes the only observatory on benign VAE in France. The reporting rate was much higher after the pandemic vaccine than after the seasonal vaccine, which may be a reflection of stimulated reporting. This report provides a useful description of VAE among military personnel during a mass emergency vaccination program, showing that the tolerance of the pandemic vaccine appeared acceptable.

Normalization of the sleep–wake pattern and melatonin and 6‐sulphatoxy‐melatonin levels after a therapeutic trial with melatonin in children with severe epilepsy

This study evaluated the sleep-wake pattern, plasma melatonin levels and the urinary excretion of its metabolite, 6-sulphatoxy-melatonin among children with severe epileptic disorders, before and after a therapeutic trial with melatonin. Ten paediatric patients, suffering from severe epileptic disorders, were selected and given a nightly dose of 3 mg of a placebo, for 1 wk; for the next 3 months, the placebo was replaced with a nightly dose of 3 mg of melatonin. At the end of each treatment period, the urinary excretion of 6-sulphatoxy-melatonin (for the intervals 09.00 - 21:00 hr or 21:00-09:00 hr) and plasma levels of melatonin (recorded at 01:00, 05:00, 09:00, 13:00, 17:00 and 21:00 hr) were recorded, over a period of 24 hr; an actigraph record was also kept. Sleep efficiency among patients who received melatonin was significantly higher than among those given the placebo, with fewer night-time awakenings. Periodic plasma melatonin levels were regained and a better control gained of convulsive episodes, in that the number of seizures decreased. We conclude that melatonin is a good regulator of the sleep-wake cycle for paediatric patients suffering from severe epilepsy, moreover, it to a better control of convulsive episodes.

Diphenyl diselenide-induced seizures in rat pups: possible interaction with GABAergic system

Objectives: The involvement of the GABAergic system in seizures induced by diphenyl diselenide (PhSe)2 in rat pups was investigated.Methods: To this end, the effect of aminooxyacetic acid hemihydrochloride (AOAA, 20 mg/kg; by intraperitoneal route, i.p.), a GABA-T inhibitor; DL-2,4-diamino-n-butyric acid hydrochloride (DABA, 16 mg/kg; i.p.), an inhibitor of GABA uptake; and γ-aminobutyric acid (GABA, 10 and 40 mg/kg; i.p.), diazepam (3 mg/kg; i.p.) and phenobarbital (40 mg/kg; i.p.), GABAergic agonists as well as picrotoxin (1 mg/kg; i.p.), a GABAA receptor antagonist on (PhSe)2 (50 and 500 mg/kg, by oral route, p.o.)-induced seizures, were studied. The [3H]GABA uptake levels by cortical and hippocampal slices in rat pups exposed to (PhSe)2 were also carried out.Results: Pre-treatment with GABA (40 mg/kg), diazepam, phenobarbital, AOAA and DABA abolished the appearance of seizures induced by 50 mg/kg (PhSe)2 in rat pups. Picrotoxin increased the percentage of convulsing rat pups from 42 to 100% and reduced significantly the onset for the first convulsive episode induced by (PhSe)2 at the dose of 50 mg/kg. Diazepam and phenobarbital prolonged significantly the latency for the onset of the first convulsive episode caused by 500 mg/kg (PhSe)2 in rat pups. [3H]GABA uptake levels were stimulated in cerebral cortical and hippocampal slices of convulsing rat pups administered with both doses of (PhSe)2.Discussion: Our findings demonstrated that seizures induced by (PhSe)2 are mediated, at least in part, by an interaction with GABAergic system.

Gray matter lesions in Nasu-Hakola disease: A report on three autopsy cases

Nasu-Hakola disease is an autosomal recessively inherited disease characterized by lipomembranous polycystic osteodysplasia and sclerosing leukoencephalopathy. While white matter lesions prominent in the brain have been reported in the literature, gray matter lesions have not received particular attention. In this study, we examined three autopsy cases of Nasu-Hakola disease in order to focus specifically on gray matter lesions. The ages at onset of the three cases were 20, 23 and 29 years, and the disease durations were 29, 19 and 8 years, respectively. In addition to characteristic degeneration in the cerebral white matter, such as demyelination with conspicuous fibrillary gliosis and axonal changes, all three cases showed overt pathology in the gray matter. Neuronal loss with gliosis in the thalamus (particularly in the dorsomedial nucleus and anterior nucleus), caudate nucleus, putamen and substantia nigra was prominent in all cases, and the severity corresponded to the disease duration. The cerebral cortices were relatively preserved in all cases. One case showed neuronal loss and gliosis in the gray matter of the hippocampus, possibly due to repeated episodes of epileptic convulsions. These gray matter pathologies are considered to be responsible for some of the clinical manifestations of the disease, including extrapyramidal symptoms.

Partial epilepsy complicated by convulsive and nonconvulsive episodes of status epilepticus in a patient with ring chromosome 14 syndrome

Epilepsy is the most common and serious neurological symptom in ring chromosome 14 syndrome, also characterised by mild dysmorphisms, acquired microcephaly, cognitive impairment, hypotonia and ocular abnormalities. Typically, early-onset, polymorphous and drug-resistant seizures are reported. Status epilepticus has not been previously reported. We describe a nine-year-old Caucasian boy with ring 14 syndrome who presented a severe early-onset and drug-resistant focal epilepsy with secondary generalised seizures and repetitive episodes of convulsive and non-convulsive status epilepticus. The electro-clinical evaluation of prolonged seizures and their long-term consequences is important for the practical management of these patients and for a better comprehension of the syndrome.

Short- and long-term anxiogenic effects induced by a single injection of subconvulsant doses of pilocarpine in rats: investigation of the putative role of hippocampal pathways

Behavioral consequences of convulsive episodes are well documented, but less attention was paid to changes that occur in response to subconvulsant doses of drugs. We investigated short- and long-term effects of a single systemic injection of a subconvulsant dose of pilocarpine on the behavior of rats as evaluated in the elevated plus maze. Pilocarpine induced an anxiogenic-like profile 24 h later, and this effect persisted for up to 3 months (% of time spent on open arms at 24 h, control = 35.47 ± 3.23; pilocarpine 150 = 8.2 ± 2.6; 3 months, control = 31.9 ± 5.5; pilocarpine 150 = 9.3 ± 4.9). Temporary inactivation of fimbria-fornix with lidocaine 4% promoted an anxiolytic-like effect per se, suggesting a tonic control of this pathway on the modulation of anxiety-related behaviors. Lidocaine also reduced the anxiogenic-like profile of animals tested 1 month after pilocarpine treatment (% of time spent on open arms, saline + phosphate-buffered saline (PBS) = 31.7 + 3.7; saline + lidocaine = 54.4 + 4.7; pilocarpine + PBS = 10.3 + 4.1; pilocarpine + lidocaine = 40.1 + 9.1). To determine whether the anxiogenic-like effect was mediated by septal region or by direct hippocampal projections to the diencephalon, the neural transmission of post-commissural fornix was blocked, and a similar reduction in the anxiogenic-like effect of pilocarpine was observed. Our findings suggest that a single systemic injection of pilocarpine may induce long-lasting anxiogenic-like behavior in rats, an effect that appears to be mediated, in part, through a direct path from hippocampus to medial hypothalamic sites involved in fear responses.

Anticonvulsant Activity of Ethanol Leaf Extract of Spathodea campanulata P. Beauv (Bignoniaceae)

The anticonvulsant properties of ethanol leaf extract of Spathodea campanulata, a plant used in traditional medicine to treat convulsion and epilepsy, were studied in mice using pentylenetetrazole-, picrotoxin-, and electroshock-induced models in mice. Other central nervous system effects and anticonvulsant-related activities such as the effects on position sense, righting reflex, Rota-Rod performance, phenobarbital sleep time, and amphetamine-induced stereotypy were also investigated. The acute toxicity potential in mice was determined by the oral route. The results showed that the administration of S. campanulata extract (250-1,000 mg/kg, p.o.) 30 minutes prior to intraperitoneal administration of pentylenetetrazole (70 mg/kg) or picrotoxin (5 mg/kg) protected the treated mice against the respective pentylenetetrazole- and picrotoxin-induced convulsion in a dose-dependent manner, offering 100% protection at the maximum dose of 1,000 mg/kg. The extract increased the threshold of maximum electroshock and reduced duration of convulsive episodes, dose-dependently. Oral administration of S. campanulata ethanol extract did not significantly (P > .05) affect other centrally coordinated behaviors and convulsion-related properties such as position sense, righting reflex, Rota-Rod performance, phenobarbital sleep time, and amphetamine-induced stereotypy in treated animals. The oral median lethal dose of the extract was estimated as 4.5 g/kg. These results show that the ethanol leaf extracts of S. campanulata possess anticonvulsant activity. The results also show that S. campanulata extract is nonsedating, has no antipsychotic properties, and may not affect motor coordination when used as an anticonvulsant.