Genuine Epilepsy Research Articles

STUDIES OF THE ROLE FOR DIHYDROPYRIMIDINASE RELATED PROTEIN 2 IN FORMATION OF EPILEPTIC SEIZURES IN EXPERIMENTAL MODEL AND CLINICS

Article concerns results of the studies of the epileptic seizures carried out on the model of male rabbits of Chinchilla species and on the epileptic patients. In the 1 st series of studies after administration of 300 units of natrium penisillinum into the amygdala of the rabbits and induction of epileptic seizures blood samples were taken from them and with application of solid-phase indirect ELISA-test the level of dihydropyrimidinase-related protein 2 (DRP2) in the platelets and the level of anti-DRP2 autoantibodies in the serum were evaluated. During seizures downregulation of both DRP2 in the platelets (p<0.05), and anti-DRP2 autoantibodies in the serum (p<0.01) was revealed. In the 2 nd series of studies after achieving stable level of seizure activity in the rabbits, through cannula, earlier implanted into the brain lateral ventricle, DRP2 in a volume of 10 µL and concentration 0.7 mg/mL, in buffered saline solution (pH 7.3) was administered and 5 min later suppression of seizures was noted. In the 3 rd series of studies blood samples were taken from the veins of the patients having diagnosis of genuine epilepsy and with application of indirect ELISA- test the level of DRP2 in the platelets was measured and drastic, 3-fold upregulation of DRP2 (p<0.001) was revealed. The results presented in the article demonstrate prominent stabilizing role for serotonergic system and its sub-cellular signal proteins in regulation of excitation processes of brain cells and realization of inhibitory effects on formation of epileptic activity.

The causes of epilepsy: Changing concepts of etiology of epilepsy over the past 150 years

This paper provides a survey of the changing concepts of the etiology of epilepsy from 1860 to 2010, focusing on the first two 50-year periods and outlining more briefly major developments in the past 50 years. Among the concepts reviewed in the first 100 years are: the division between predisposing and exciting causes, idiopathic and genuine epilepsy, organic epilepsy, the concept of "cause" being equivalent to "causal mechanism," Russell Reynolds etiological classification, the neurological taint and theories of degeneration, the self-perpetuating nature of seizures, reflex theories of etiology, autointoxication, heredity and eugenics, epilepsy due to brain disorders, the role of EEG and of hippocampal sclerosis, psychological theories of causation, and the multifactorial view of epilepsy etiology. In the past 50 years, the major advances in studying causation in epilepsy have been: clinical biochemistry, neuroimaging, molecular genetics, studies of mechanisms of epilepsy, better statistical methodologies and classification. A number of general observations can be made: the identification of "cause" is not as simple as it might at first appear; progress in the study of causation has been often erratic and travelled up many cul-de-sacs; theories of causation are heavily influenced by societal influences and fashion, and is also heavily dependent on applied methodologies; the recently explored possibility that the underlying inherited mechanisms of epilepsy are shared with other neuropsychiatric conditions is in effect a reinvention of the concept of the neurological trait, and this has ethical and social implications. Considering and classifying cause in terms of causal mechanism, as was suggested by Hughlings Jackson, is an ultimate goal.

Seizure response dogs: Evaluation of a formal training program

Evidence supporting seizure-related behaviors in dogs is emerging. The methods of seizure response dog (SRD) training programs are unstudied. A standardized survey was retrospectively applied to graduates of a large SRD program. Subjective changes in quality of life (QOL) parameters were explored. Data were captured on animal characteristics, training methods, response and alerting behaviors, effects on seizure frequency, and accuracy of epilepsy diagnosis. Twenty-two patients (88%) participated (median age=34, range=12-66, 73% female). Most had childhood-onset epilepsy (87%) that was refractory with averages of 36 seizures/month and 4.8 medications failed. All had neurologist-confirmed epilepsy, most being symptomatic partial (64%). SRD behaviors were reliable, including emergency response system activation in 27%. All reported SRD-related QOL improvements (major 82%, moderate 18%) across multiple parameters. Spontaneous alerting behavior developed in 59%. That SRD programs may select genuine epilepsy patients, instill valuable assistance skills, and generate meaningful QOL improvements supports further seizure dog research.

Non-epileptic seizures and child sexual abuse: A critical review of the literature

Non-epileptic seizures have received a substantial amount of attention in the psychiatric and medical literature, but comparatively little attention from psychologists. Non-epileptic seizures resemble epileptic seizures but lack the physiological symptoms of genuine epilepsy and are psychological in origin. Many authors have emphasized the role that child sexual abuse may play in the etiology of this disorder. In the present paper, we provide a review of 34 studies examining this relationship, followed by a meta-analysis of 19 effect sizes. While our statistical results support the professed link between child sexual abuse and non-epileptic seizures, we suggest that because of research design limitations, it is premature to draw any definitive conclusions regarding a relationship. Eight of these research design limitations are identified and discussed (e.g., the absence of comparison groups; an explicit and public definition of child sexual abuse). Alternatives to a traditional psychoanalytic perspective that emphasizes the role of child sexual abuse in the etiology of NES are presented. Specific recommendations for future research are made and psychologists are strongly encouraged to play a more active role in both researching and treating non-epileptic seizures.

Prevalence of genuine epilepsy among adult emergency patients with an episode of unconsciousness

Objective: Loss of consciousness (LOC) is caused by a variety of conditions including epileptic, cardiac, psychiatric, and autonomic disorders. We investigated the prevalence of presenting attacks of genuine epilepsy among patients of Emergency Department and Department of Cardiology evaluated for an episode of LOC with or without a convulsion. Patients and methods: We retrospectively studied 371 adults presenting to the Emergency Department and Department of Cardiology of our hospital from 1991 to 1999 with a chief complaint of an episode of LOC with or without a convulsion. Ages ranged from 15 to 78 years. Patients were free of severe chronic illnesses, drug abuse, and alcoholism. LOC was considered to represent genuine epilepsy either when the interictal electroencephalogram (EEG) showed epileptiform discharges in the absence of imaging abnormalities, or when both the EEG and imaging studies were unrevealing but one or more previous attacks had occurred and administration of an anticonvulsant prevented subsequent attacks. Results: Patients included 302 patients without a convulsion, and 69 patients with a convulsion. Of the former, 14 subjects had epileptiform discharges on EEG, and three subjects had no epileptiform discharges but had three or four attacks of LOC that were abolished by anticonvulsant therapy. Of the 69 patients with a convulsion, seven had epileptiform discharges, and 12 had two to five attacks, no epileptiform discharges, and a response to anticonvulsant therapy. Conclusions: The prevalence of presenting attacks of genuine epilepsy in 371 adult patients with an episode of LOC was remarkably high (9.7%: 36 subjects).

Schizophrenic Syndromes in Epilepsies (Part 5 of 7)

Following a historical review and critical appraisal of the literature (problems of definition, selection, frequency, etiology, relation and classification) clinical findings from a series of retrospective and prospective studies (four samples with altogether 47 epileptic patients) are presented and discussed, as well as the results of EEG, CT and other relevant investigations. (1) ‘Schizophrenia-like’ interictal (periictal) psychoses in the epilepsies, which are not rare, appear to be true schizophreniform (= schizophrenic-accentuated) syndromes in a setting of ‘clear’ consciousness. There is no case of alternative psychosis and EEG ‘forced normalization’. (2) Between schizophrenic-accentuated syndromes associated with regularly symptomatic epilepsies and genuine (endogeneous) schizophrenias, there are quantitative but no qualitative differences. Often there is a congruence and no possibility of differentiating in the transverse study. This is also true both for the affective and the cognitive disturbances (‘structure of consciousness’); the latter are not suitable for separating the psychopathological syndromes of epilepsies. A discrimination between ‘genuine’ and ‘symptomatic’ schizophrenia is no longer meaningful. (3) A true (hereditary) coincidence of (genuine) epilepsy and schizophrenia occurs obviously very seldom. (4) Numerous findings are presented, concerning the conditions in which schizophrenic-accentuated syndromes appear. The following relevant factors are discussed: hereditary, latency, duration of illness, type and frequency of seizures, type and localization of EEG foci, type, extent and topography of brain lesions, quantity and quality of psychopathological findings as well as ‘organic’ psychosyndromes. The possible triggering of psychoses by psychosocial factors, low intelligence, chronic folate deficiency and other specific risk factors and the role of neurotransmitter disorders (GABA hypotheses) are discussed. Finally proposals are made concerning prevention and therapy. Especially often diagnosed non-alternative schizophrenic syndromes in epileptic patients must be controlled by blood levels of antiepileptics. There is a transitional rank, constituted by defined determinants between the poles epilepsy and schizophrenia or a converging course of those syndromes. The results should lead to more frequent EEG and CT eventual magnetic resonance imaging or positron emission tomography-investigations in schizophrenic patients.

New anticonvulsants in pediatrics: Carbamazepine and valproate

The majority of patients with epilepsy have their first seizure during childhood and are first evaluated and diagnosed by their pediatrician. For many patients the medication selected by the pediatrician will be taken for an extended time period, perhaps even for a lifetime. The first job of the pediatrician is to be sure that the patient's recurrent attacks represent genuine epilepsy and not some other paroxysmal medical disorder such as migraine or cardiac arrhythmias. Epileptic seizures are then classified by a careful clinical description of the attacks in conjunction with the results of the physical and EEG examinations. Based on all of the information at hand, the clinician chooses the drug that is most likely to reduce or eliminate further seizures without exposing the child to unnecessary medical risk or behavioral-cognitive adverse effects. In properly selected patients, both carbamazepine and valproate are safe, physically well tolerated, and less likely to provoke chronic mental side effects than the pediatrician's “traditional” choices: phenobarbital or phenytoin. Although carbamazepine and valproate have been widely acclaimed by neurologists and epileptologists, practicing pediatricians have heretofore been less likely to initiate treatment with these drugs. Yet pediatricians have something of priceless value to offer the child with epilepsy: seizure control and a clear mind. The information in this monograph should assist the practicing pediatrician in the rational choice, initiation, and follow-up of treatment with these two excellent anticonvulsants.

Quantitative determination of immunoglobulins in cerebrospinal fluid.

A modification of Merrill et al.'s method is described for determination of IgG in cerebrospinal fluid in diseases of the central nervous system. The following electrophoretic conditions for 10μl of nonconcentrated cerebrospinal fluid were satisfactory: current density of 60 mA, potential difference of 90 V, and electro-phoretic time of 90 minutes. Serial dilutions of a standard IgG specimen were used as controls each time together with test samples. In normal subjects the IgG level in cerebrospinal fluid ranged within 1.44±0.53 mg/100 ml. It was higher in multiple sclerosis, postvaccinal encephalitis, measles encephalitis, neuro-syphilis, meningitis and obstruction of the spinal canal, but lower in genuine epilepsy. IgG in cerebrospinal fluid in degenerative diseases and myeloneuropathy with abdominal signs (SMON) were within normal range. In brain tumors no constant IgG pattern was found. IgG% (IgG concentration/total protein concentration×100) in multiple sclerosis, postvaccinal encephalitis, measles encephalitis, tuberculous meningitis and neurosyphilis was increased, but that in obstruction of the spinal canal remained within the normal range.

Inorganic substances in encephalon tissues in schizophrenia.

Summary Electrolyte contents in enecphalon of human being and animals were measured and led to the following results and conclusions. Subjects consisted of 33 cases of schizophrenia as the center, 3 of mania, 1 of depression, 6 of oligophrenia, and 2 of genuine epilepsy, besides dogs and rats. 1) In dog encephalon K content measured 381 mg% in the gray matter and 392 mg% in the white matter, Na content 164 mg% in the gray and 138 mg% in the white matter; Ca content 8.2 mg% in the gray matter and 7.3 mg% in the white matter and Mg content 15.2mg% in the gray and 16.0 mg% in the white matter. 2) In rat encephalon K content in the gray matter measured 405 mg%, Ca content 6.8 mg% in the gray and 6.9 mg% in the white matter and Mg content 13.5 mg% in the gray substance. 3) The ratio of Ca content in the gray matter to that in the white matter read 1.12 in dogs and 0.99 in rats, making an unignorable difference between the two. 4) The ratio of Mg content between the gray and white matter disclosed that in dogs as well as in rabbits Mg content stood higher in the white matter than in the gray. 5) In human encephalon of the control group, K amounted to 363 mg% in the gray matter and 274 mg% in the white one, Na to 145 mg% in the gray matter and 114 mg% in the white one, Ca to 7.9mg% in the gray matter and 9.3mg% in the white one and lastly Mg to 16.4mg% in the gray and 18.1 mg% in the white matter. 6) In encephalon of the schizophrenic group, K amounted now to 470mg% in the gray matter and 269mg% in the white matter, Na to 137mg% in the gray matter and 113mg% in the white one and Ca to 8.8mg% in the gray matter and 9.3mg% in the white, while Mg to 16.2 mg% in the gray and 18.0 mg% in the white matter. 7) To summarize, K content in the gray matter stood slightly higher in the schizophrenic group than in the control. The ratio of K content in the gray matter against that in the white underwent fluctuation more widely in the former as in the latter. 8) Ca ratio of the gray matter against the white matter came out higher in the schizophrenic group than in the control. 9) The control and the schizophrenic group did not differ in Mg content with each other. 10) In the schizophrenia. group a fluctuation was recognized concerning series of the ratios of K content in the gray matter against Ca in the white matter. 11) A balance between K content in the blood plasma and that in the gray matter went lost appreciably in the schizophrenic group. Finally, it was confirmed on the basis of those results that in the schizophrenic patients the unusual changes did occur in such electrolytes as K and Ca in encephalon and K in the blood plasma. in addition to this, those electrolytes are broken down by virtue of the enzymatic, biochemical and physiological chain reactions, consequently as to develop morbid change in encephalon. The essential parts of this article were already made public both at the fiftieth general meeting of Society of Neurology and Psychiatry of Japan in May, 1953 and at the general meeting of Tohoku Society of Neurology and Psychiatry in November, 1954. In closing this article the author wishes to express his heartful thanks to Prof. Dr. T. Kamimura who gave guidance and revised this article and Dr. T. Kojima who gave encouragement throughout his study.

Nucleases in the cerebrospinal fluid. I. Ribonuclease in normal, neurologically normal, and in pathological CSF's.

Ribonuclease (RNA-ase) was investigated in 800 individual CSF samples. The uranylacetate precipitation technique of MacFadyen was used, followed by total acid soluble phosphorus determinations (King) before and after incubation. Normal and neurologically normal CSF's showed low RNA-ase activity. The values ranged under 20% substrate depolymerized in 24 hr. A few exceptions showing high values were encountered: one specimen each of acute nasopharyngitis, 25%; infectious mononucleosis, 28%; and myositis, 30%. The meningitis CSF's showed a wide range of RNA-ase activity, 0-50%. Poliomyelitis specimens exhibited uniformly the highest values, 15-52%. This high RNA-ase activity paralleled chronologically the chromatolysis of the motoneurons and is of special significance. In the syphilis group only the neurosyphilis samples presented moderately high activity, but rarely attained the levels observed in meningitis and in poliomyelitis. In miscellaneous neurological conditions the highest activity was found in a specimen from a case of genuine epilepsy. The findings are discussed in detail.

Effects of intensive psychotherapy on epileptic children; report on three children with idiopathic epilepsy.

THE PSYCHIATRIC study of genuine epilepsy has produced information which strongly suggests that psychologic factors play a role in the elaboration or exacerbation of epileptic phenomena. The literature on psychopathology of epilepsy has been thoroughly reviewed elsewhere.1Various studies, mostly clinical, have led to the development and elaboration of hypotheses concerning the psychobiological functions of both the aura2and the seizure manifestations.3 If psychopathological hypotheses of the origin of the epileptic syndrome have some basis in fact, there should be a possibility through psychologic means of modifying the frequency and/or form of the seizures in certain epileptic patients. The neurophysiological correlates of epileptogenic phenomena, such as the electroencephalogram, may possibly also be modifiable through psychologic means. Barker and Barker4and others, for instance, have collected evidence that exploratory psychologic investigations may modify the cerebral bioelectric activity of known epileptic patients. They have interviewed epileptic subjects during

DORSOMEDIAL THALAMOTOMY (I) THE PRINCIPLES AND METHODS, PARTICULARLY CONSULTED WITH E. E. G. RECORDS

Summary Concerning the principles and methods of dorsomedial thalamotomy, thought out and executed by the author for the first time, descriptions as well as comments have been given The two cases operated for the first time, schizophrenic patient and a genuine epileptic one, showed definite improvements clinically. This operation affords a promising prospect for clinical application with psychoses, particularly with genuine epilepsy.

SOME INFORMATIONS ON DIABETES MELLITUS AFTER CAUDAL RESECTION OF THE PANCREAS IN A GENUINE EPILEPTIC

In our 28 epileptics hyperglycemia after the partial resection of the pancreas (caudal 3/5 of the entire organ) as a. cure for genuine epilepsy returned to the normal level mostly 2-3 weeks after the operation, but in only one case there was a persisting diabetes mellitus, where caudal 4/5 was resected. From our clinical results it may be conceivable that diabeltes mellitus after this operation should be prevanted by the protection of the islets by means of alimentotherapy, if the functions of the pituitary, adrenal or thyroid glands are normal. In this diabetic case the x-radiation on the pituitary gland and the superior cervical sympathetic ganglionectomy resulted in the decrease of the sugar level of blood or urine, and also the administration of estrogen resulted in the obvious decrease of blood sugar level if the pituitary gland not so much atrophied.

Genetical and Clinical Researches in Genuine Epilepsy

SUMMARY Investigating 136 cases of genuine epilepsy who have typical grand mal attacks both from the genetical and clinical standpoints, we succeeded in bringing about the following results: The cases of simple family features, such as those who have no hereditary taint except epilepsy in their family stocks, have generally simple clinical features, and their seizures are limited to the motor sphere, externally manouvering convulsive attacks. On the other hand, the cases of polymorphic family features, such as those who possess psychoses or psychopathic personality in their family stocks, have mostly polymorphic clinical features, and their seizures tend to reach beyond the motor sphere to the psychic one, externally manouvering clouded states, deliria, etc. The degree of deterioration in the latter cases is altogether less notable than that in the former. From these facts we may assume that genuine epilepsy belongs, not only clinically but also genetically speaking, to the heterogenous category. That is to say, it can be classified into two principal group of simple manifestation in both clinical and genetical respects (the nuclear group) and that of polymorphic ones (the peripheral group).

Myoclonus Epilepsy: Report Of Electroencephalographs Observations

Summary A patient diagnosed as myoclonus epilepsy and in the initial stage of progressive familial myoclonia of Unveriedt was electroencephalogyaphically studied and subjected later to statistical analysis. While the frontal region showed the highest; abnormality electrically, in electroencephalohraphic aspect series of uniform at appearance of the clusterg in the bursts of spikeformed waves combined with myoclonical movements in clinical side made up specific feature of this disease. This item interpreted in noso1ogic;il sense and in light of the changes in the records in untouched course of the patient arid under medication, the disease represent a variation of genuine epilepsy. There is a study of familial hereditary relationship through records o f the brother, another myoclonus epilepsy case, the mother and the grandfather of maternal side.

On Genuine Epilepsy

On Genuine Epilepsy

CONVULSIONS OF EARLY LIFE AND THEIR RELATION TO THE CHRONIC CONVULSIVE DISORDERS AND MENTAL DEFECT

My own observations and a study of the literature point to a general agreement, in regard to certain factors, among those working on the problem of infantile convulsions and their relation to subsequent neuro-psychiatric disorders. 1. Convulsions repeated over a period of weeks or months during early life are more likely to be followed by than a single convulsion or a series of convulsions occurring within a relatively short period of a few days or hours. 2. A larger number of children have convulsions during the first year than at any other time. Husler(14) judges that in 41 per cent of his cases the onset of was at the age of four. This was not substantiated by our recent study where convulsions beginning in the first year were more frequently followed by serious results. Schrenk(15) finds that the peak in genuine epilepsy occurs around the second and the seventh-eighth year of life while the peak in symptomatic epilepsy is definitely in the first year of life. 3. The so-called id...

ORGANIC SYMPTOMS FROM THE CENTRAL NERVOUS SYSTEM IN SO‐CALLED GENUINE EPILEPSY

Acta Psychiatrica ScandinavicaVolume 6, Issue 2-3 p. 209-212 ORGANIC SYMPTOMS FROM THE CENTRAL NERVOUS SYSTEM IN SO-CALLED GENUINE EPILEPSY H. P. STUBBE TEGLBJÆRG, H. P. STUBBE TEGLBJÆRG DIANALUND, DENMARKSearch for more papers by this author H. P. STUBBE TEGLBJÆRG, H. P. STUBBE TEGLBJÆRG DIANALUND, DENMARKSearch for more papers by this author First published: September 1931 https://doi.org/10.1111/j.1600-0447.1931.tb09503.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume6, Issue2-3September 1931Pages 209-212 RelatedInformation

MONOBROMATED CAMPHOR

The experimental production of fits by drugs has been a particularly interesting branch of research in epilepsy. Many workers, especially Magnan, 1 Horsley, Boyce, Russell, Turck, Turtschaninow, Purkinje and Muskens 2 have used various drugs and attempted to explain epileptiform phenomena on the basis of the effects produced by these drugs. However, these researches have failed to reveal any one drug that will cause effects exactly comparable with genuine epilepsy. Of all the drugs used, camphor or its derivatives appears to be the substance best suited for the experimental study of fits. For many years, camphor has been known to produce convulsions in warm-blooded animals, and not infrequently in man through an overdose. Alexander, in 1829, and later Wiedemann 3 (1877) described the convulsive effects of the drug as epileptiform. Later. Schwartz (1871). Gubler (1874), Pathault 4 (1876) and Lawson 5 (1897), described its effects on the nervous systems of

EPILEPSY OF THE ANGIOSPASTIC VARIETY IN MONOZYGOTIC TWINS

Human twins and twins of the animal kingdom generally have always been objects of interest because of their striking external similarity. Human twins of complete identity or, as they are technically designated, identical or duplicate twins, are of special interest because of their identical sex and external likenesses. The twins of this report are of double interest, (1) because of the apparent external identity of features and sex and (2) because of a like pathologic disturbance found in them, namely, that of genuine epilepsy. REPORT OF A CASE The twins came to the clinic on Feb. 3, 1927, because of and since then I have observed them from time to time. Glen and Irvin, later to be referred to as G and I., were identical twins, born one minute apart in 1916. The history of the parents and of their known relatives was without significance. Twinning, epilepsy, alcoholism and