Incidence Of Epileptic Seizures Research Articles

Safety and Efficacy of Levetiracetam for Prevention of Epileptic Seizures in Acute Phase of Intracerebral Bleeding

Background: Epilepsy, characterized by recurrent, unprovoked seizures due to anomalous brain activity, is a significant complication for patients with intracerebral hemorrhage (ICH). The onset of epileptic convulsions during the acute phase of ICH can worsen the patient's prognosis and survival chances, making it crucial to identify a safe and effective method to prevent these seizures. Levetiracetam, a pyrrolidone derivative, is noted for its unique mechanism of action, exceptional tolerability, and advantageous pharmacokinetics, making it efficacious against various types of seizures. Objective: This study aims to evaluate the safety and efficacy of levetiracetam in preventing epileptic seizures during the acute phase of ICH and to determine its impact on neurological outcomes in this patient population. Methods: A cross-sectional investigation was conducted between October 2022 and June 2023 at Pak Emirates Military Hospital in Rawalpindi, Pakistan, involving 85 patients with spontaneous ICH confirmed by CT or MRI within 24 hours of symptom onset. Inclusion criteria included adult patients aged 18 or older, with various forms of ICH, excluding isolated subarachnoid hemorrhage, penetrating wound injury, depressed skull fracture, or early posttraumatic seizure. Patients with a Glasgow Coma Scale (GCS) score of less than 6, serum creatinine level >1.7 mg/dL, history of psychosis, unprovoked seizures, cerebrovascular accidents, traumatic brain injuries, or encephalitis within the previous three years were excluded. Patients were administered an initial loading dose of levetiracetam (1,000 to 1,500 mg), followed by a maintenance dose (500 to 1,500 mg every 12 hours) based on renal function. Continuous electroencephalography (cEEG) monitoring was used to detect seizures for at least the first 72 hours of hospital admission. The primary outcome was the incidence of epileptic seizures during hospitalization, while the secondary outcome was the patient's neurological status at discharge, assessed using the Modified Rankin Scale (mRS). Data were analyzed using descriptive statistics and the Chi-square test, with a p-value of ≤0.05 considered statistically significant. Analyses were conducted using SPSS version 25. Results: The mean age of the patients was 47.89 years (SD=7.46), with 62.35% male and 37.65% female. The mean GCS score at admission was 10.52 (SD=2.13), and the mean volume of ICH was 17.5 ml (SD=3.4). At baseline, 2.35% of patients had GCS scores of 3-5, which improved to 0% after treatment. The percentage of patients with GCS scores of 13-15 increased from 65.88% to 83.52% (p=0.3730). Seizures within the first 7 days occurred in 10.58% of patients, and the overall seizure incidence during hospitalization was 20%. At discharge, 9.41% of patients had an mRS score of 0, and the percentage of patients with an mRS score of 2 increased significantly from 18.18% to 37.64% (p=0.4086*). The percentage of patients with severe disability (mRS score of 5) significantly decreased from 22.72% to 5.68% (p=0.0094*). Conclusion: Levetiracetam is effective in improving neurological outcomes and reducing the incidence of seizures in patients with acute intracerebral hemorrhage, with a manageable safety profile. These findings suggest that levetiracetam can be a valuable addition to therapeutic strategies for managing ICH-related seizures, potentially enhancing patient care and improving health outcomes.

A Comparison of Post-Stroke Seizure Rates in Patients Receiving IV Thrombolytic, Mechanical Thrombectomy, and Conventional Treatment Following Acute Ischemic Stroke

Objective: The incidence of epileptic seizures after a stroke falls within a range of 2.3-43%. Varying opinions exist in the literature concerning the association between thrombolytic therapy, endovascular interventions, and the development of epileptic seizures post-stroke. Material and Methods: Seizure rates were compared based on the treatment method (thrombolytic therapy, endovascular intervention, or conventional therapy) in patients experiencing acute ischemic stroke within a two-year period in the neurology and neurology intensive care unit. Patients were categorized into three groups: the first group received IV thrombolytic therapy, the second group underwent mechanical thrombectomy, and the third group received conventional therapy. The occurrence of epileptic seizures from hospitalization to discharge was compared. Results: IV thrombolytics were administered to 1.5% of patients, mechanical thrombectomy to 3.6%, and 94.9% received medical treatment. Epileptic seizures were observed in 0.9% of patients. No statistically significant relationship was found between the development of epileptic seizures and the treatment method for ischemic stroke. Furthermore, no statistically significant correlation was identified between the development of epileptic seizures and the modified Rankin score at discharge. Conclusion: Our findings align with existing studies. In conclusion, this retrospective study aimed to assess how the treatment method applied in acute ischemic stroke might influence the background of epileptic seizures.

Levetiracetam Versus Levetiracetam Plus Sodium Channel Blockers for Postoperative Epileptic Seizure Prevention in Brain Tumor Patients.

BackgroundBrain tumor patients tend to develop postoperative epileptic seizures, which can lead to an unfavorable outcome. Although the incidence of postoperative epileptic seizures and adverse events are improved with the advent of levetiracetam (LEV), postoperative epilepsy occurs at a frequency of 4.6% or higher. In brain tumor patients, the addition of sodium channel blockers (SCBs) to LEV significantly reduces seizures, though confirmed in a non-postoperative study. Thus, the combination of SCBs with LEV might be promising.ObjectiveIn this prospective randomized controlled trial we investigated the safety, evaluated by adverse events during one and two weeks after surgery, and the efficacy, evaluated by the incidence of early epilepsy, including non-convulsive status epilepticus (NCSE), of using LEV alone or SCBs added to LEV in patients who underwent craniotomy or biopsy for brain tumors or brain mass lesions.MethodsPatients with brain tumors or brain mass lesions undergoing surgical interventions, excluding endoscopic endonasal surgery (EES), with a diagnosis of epilepsy were eligible for this study. Patients are randomized into either Group A or B (B1 or B2) after the informed consents are taken; LEV alone in Group A patients, while LEV and SCBs in Group B patients (GroupB1, intravenous fosphenytoin plus oral lacosamide (LCM) and GroupB2, intravenous LCM plus oral LCM) were administered postoperatively. Fifty-three patients were enrolled during the first two and a half years of the study and four of them were excluded, resulting in the accumulation of 49 patients’ data.ResultsPostoperative epileptic seizures occurred only in three out of 49 patients during the first week (6.1%) and in seven patients within two weeks after surgery (14.3%, including the three patients during the first week). In Group A, epileptic seizures occurred in two out of 26 patients during the first week (7.7%) and in five patients within two weeks (19.2%) after surgery. In Group B, epileptic seizures occurred in one out of 23 patients during the first week (4.3%) and in two patients during the first two weeks (8.7%). Low complication grade of epileptic seizures was observed in Group B rather than in Group A, however, without significant difference (p=0.256). There was no difference in the frequency of adverse effects in each group.ConclusionAlthough not statistically significant, the incidence of epileptic seizures within one week after surgery was lesser in LEV+SCBs groups than in LEV alone. No hepatic damage or renal function worsening occurred with the addition of LCM, suggesting the safety of LEV+SCBs therapy.

Individual participant data meta-analysis of intervention studies with time-to-event outcomes: A review of the methodology and an applied example.

Many randomized trials evaluate an intervention effect on time‐to‐event outcomes. Individual participant data (IPD) from such trials can be obtained and combined in a so‐called IPD meta‐analysis (IPD‐MA), to summarize the overall intervention effect. We performed a narrative literature review to provide an overview of methods for conducting an IPD‐MA of randomized intervention studies with a time‐to‐event outcome. We focused on identifying good methodological practice for modeling frailty of trial participants across trials, modeling heterogeneity of intervention effects, choosing appropriate association measures, dealing with (trial differences in) censoring and follow‐up times, and addressing time‐varying intervention effects and effect modification (interactions).We discuss how to achieve this using parametric and semi‐parametric methods, and describe how to implement these in a one‐stage or two‐stage IPD‐MA framework. We recommend exploring heterogeneity of the effect(s) through interaction and non‐linear effects. Random effects should be applied to account for residual heterogeneity of the intervention effect. We provide further recommendations, many of which specific to IPD‐MA of time‐to‐event data from randomized trials examining an intervention effect.We illustrate several key methods in a real IPD‐MA, where IPD of 1225 participants from 5 randomized clinical trials were combined to compare the effects of Carbamazepine and Valproate on the incidence of epileptic seizures.

Risk factors and surgical outcome of secondary epilepsy arising from supratentorial meningioma

Objective To elucidate the risk factors and surgical outcome of secondary epilepsy arising from intracranial meningioma. Methods A retrospective study was conducted on the clinical data of 267 patients with intracranial meningioma admitted to Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from January 2015 to December 2015. All those patients underwent surgical operations. The seizure outcome was followed up through outpatient visits or telephone post operation. Univariate analysis and Cox proportional hazards model were applied to identify the predictive factors for epileptic seizures in patients with supratentorial meningioma. Results In this series, the incidence of epileptic seizures arising from meningioma was 17.2% (46/267). Univariate analysis demonstrated 4 predictive factors for preoperative epilepsy: tumor location (perirolandic area) (P<0.01), male patients (P=0.01), young people (less than 45 years old) (P<0.01) and hydrocephalus (P<0.01). Two independent predictors were confirmed by multivariate analysis: tumor location (perirolandic area) (HR=2.21, 95%CI: 1.23~3.97, P=0.008) and young people (HR=2.03, 95%CI: 1.11~3.68, P=0.021). A total of 213 patients were successfully followed up for an average duration of 24±13 months. Also, the status seizure free was reported in 80.4% (37/46) of the meningioma patients with preoperative seizures. Conclusions Epileptic seizures are common in patients with meningiomas and more likely to be observed in those with tumors located in motor-related areas and young people. Tumor resection could result in favorable seizure outcome. Key words: Meningioma; Epilepsy; Risk factors; Prognosis; Motor cortex

Computational Investigation of Amyloid Peptide Channels in Alzheimer’s Disease

Aβ accumulation has been discovered to form large, relatively cation-permeable channels in the plasma membrane of a neuron. These channel formations in the membranes of a neuron could cause cell depolarisation, sodium and potassium dysregulation, depletion of neural energy stores and other types of cellular dysfunction. This study shows that the build-up of amyloid beta (Aβ) depositions during the onset of Alzheimer’s disease has profound effects on the activity of the local community of neurons in the central nervous system. These effects can include enhanced neural activity, spontaneous epileptiform activity and incidence of epileptic seizures. From the results in this area, it can be seen that the neurodegeneration observed in Alzheimer’s disease has been associated with the increase of toxicity of Aβ depositions. In this research paper, we examined this hypothesis in light of a computational model of a neuron.

Prevalence and risk factors of epileptic seizures in Alzheimer’s-disease

Introduction Evidence suggests that patients with Alzheimer’s disease (AD) have a higher chance to have epileptic seizures. However, only a few studies observed the risk factors for developing seizures and the semiology of seizures. The aim of our study was to examine AD patients using long-term EEG recording, to identify the prevalence, main features and the risk factors of epileptic seizures. Methods We selected 42 patients meeting the criteria for probable AD. The patients underwent rigorous clinical investigation including long-term (24 h) EEG monitoring. Epileptological data were collected by retro- and prospective analysis as well. Results We identified epileptic seizures in 24% of AD patients. 72% of seizures were complex temporal seizures and in 55% without convulsion. Early onset of cognitive decline, long duration of dementia, severe stage of the disease and high number of educational years were correlated positively to the incidence of epileptic seizures. Conclusion Epilepsy is a common comorbidity of AD. Epileptic seizures predominantly occur in highly educated AD patients with early onset dementia at the severe stage of the disease. Since the most frequent seizure type is the non-convulsive complex temporal seizure, application of long-term EEG is essential in prevalence studies. Antiepileptic treatment might represent a promising future target in AD.

Use of an antiepileptic drug to control epileptic seizures associated with cranioplasty: A randomized controlled trial

BackgroundEpilepsy is a common complication of cranioplasty. The present study was designed to explore the clinical effect of prophylactic anti-epilepsy drugs (AED) to control epileptic seizures associated with cranioplasty. Methodsand design: This trial was a prospective, randomized, open-label, single-centre, active controlled study designed to investigate the use of antiepileptic drug to control epileptic seizures associated with cranioplasty. We tested the necessity and methods of drug use. Three hundred twenty epilepsy patients who underwent cranioplasty were included in this study. The patients were randomly divided into the control group (160 cases) and the experimental group (160 cases). AED were administered to experimental group from 4 days before the surgery until 1 month after the surgery. The incidence of early and late epileptic seizures after cranioplasty was analyzed. The liver function, abnormal blood test 1 month after surgery were compared between these two groups. ResultsThe incidence of seizures in the Control group was 28.6% (43 cases in 149 cases) while in the experimental group was only 5.9% (9 cases in 151 cases), which had statistical significance. The incidence of epileptic seizure was significantly higher in patients who received no AED treatment than in those who received AED treatment. Besides, the abnormal liver function and blood routine examination in both control and experimental group had no significant differences. ConclusionThe incidence of epilepsy associated with the cranioplasty is high and early use of anti-epileptic drugs can effectively reduce the occurrence of seizures.

Most antidepressant drugs are safe for patients with epilepsy at therapeutic doses: A review of the evidence.

For a long time, there has been a misconception that all antidepressant drugs have proconvulsant effects. Yet, antidepressants of the selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) families have been not only shown to be safe when used in patients with epilepsy (PWE) but have been found to display antiepileptic properties in animal models of epilepsy. In humans randomized to SSRIs vs. a placebo for the treatment of primary major depressive episodes, the incidence of epileptic seizures was significantly lower among those treated with the antidepressants. On the other hand, SSRIs and SNRIs can display proconvulsant properties at toxic doses. This article reviews the preclinical and clinical data of antiepileptic and proconvulsant properties of these drugs and addresses special considerations to take when prescribing them for PWE.

Assessment of Pharmacological Treatment Quality: Comparison of Symptom-triggered vs. Fixed-schedule Alcohol Withdrawal in Clinical Practice.

Introduction: Despite the fact, that symptom-triggered alcohol withdrawal treatment is recommended by German guidelines on alcoholism, many hospitals continue to use fixed-schedule protocols, as they have been successfully applied for many years. Methods: This retrospective study compared all patients' records of alcohol withdrawal treatment from October 2010 to November 2011 at Magdeburg's University Department of Psychiatry (n=120). A symptom-triggered protocol with clomethiazole (AESB, n=46) was used in parallel with the existing fixed-schedule protocol with diazepam (n=74). Results: The symptom-triggered group showed less need of pharmacological treatment duration (p<0.001) and cumulative dosage of medication compared to the fixed-schedule protocol (p<0.006). No difference was observed regarding the need of clonidine or haloperidol (to treat blood pressure derailment or delirium) and the incidence of epileptic seizures. Discussion: Based on the shorter treatment duration and a similar rate of complications our department has switched to the symptom-triggered protocol to improve the quality of patient care.

PSEUDOTUMORAL FORM OF MULTIPLE SCLEROSIS WITH SYMPTOMATIC CONVULSIVE SEIZURES (A CLINICAL CASE)

Multiple sclerosis (MS) is prominent among central nervous system diseases. It affects chiefly young people and almost inevitably results in disability. In the past decade, there has been an upward trend for the prevalence of MS worldwide; in particular, the higher prevalence of this disease has been registered in the Moscow Region, which is associated with both an objective increase in its morbidity and improvement of specialized care to the population in the region. MS is characterized by a variety of clinical manifestations. However, paroxysmal disturbances are referred to as the rare symptoms of MS: the incidence of epileptic seizures in this condition is 0.89 to 7.5% according to the literature data. In addition to the clinical form of MS, there are its rare malignant atypical forms that also include its pseudotumoral form characterized by intrinsic neuroimaging and clinical signs that are different from the classical form of MS and another abnormality of the central nervous system. The pseudotumoral form of MS is characterized by the development of acute focal demyelination that appears as a large focus of an increased magnetic resonance signal with perifocal edema as evidenced by magnetic resonance imaging. A pseudotumoral focus of demyelination can occur both at the onset of MS and during its recurrent course. The atypical onset of MS is a special challenge because of diagnostic problems, which may lead to erroneous therapeutic policy and have a negative impact on the late prognosis of the disease. The authors provide a clinical case of the pseudotumoral form of MS with convulsive seizures at the onset of demyelinating disease. The problems of diagnosis and therapeutic approaches are discussed.

Different Aquaporin-4 Expression in Glioblastoma Multiforme Patients with and without Seizures

Aquaporin-4 (AQP-4), the most important water channel in the brain, is expressed by astrocyte end feet abutting microvessels. Altered expression levels of AQP-4 and redistribution of the protein throughout the membranes of cells found in glioblastoma multiforme (GBM) lead to development of the edema often found surrounding the tumor mass. Dysregulation of AQP-4 also occurs in hippocampal sclerosis and cortical dysplasia in patients with refractory partial epilepsy. This work reports on analysis of the relationship between AQP-4 expression and the incidence of epileptic seizures in patients with GBM. Immunohistochemical and polymerase chain reaction techniques were used to evaluate AQP-4 in biopsy specimens from 19 patients with GBM, 10 of who had a history of seizures before surgery. AQP-4 mRNA levels were identical in the two groups of patients, but AQP-4 expression was more frequently detected on the GBM membranes from specimens of patients with seizures than from individuals without (10 versus 2, P < 0.001). We conclude that reduced expression of cell surface AQP-4 is characteristic of GBM patients without seizures, likely attributable to a posttranslational mechanism.

Migraine, epileptic seizures and psychogenic non-epileptic seizures: Observations in Indian patients in a clinic-based study

The present study focuses on the incidence of epileptic seizures in 1000 patients (200 children and 800 adults) with migraine. Very few patients with migraine had history of epileptic seizures. No patient had migraine-induced seizures and none had seizure-induced migraine like headaches. Occurrence of psychogenic non-epileptic attacks during migraine headaches had not been highlighted in the past. In the present study, about a quarter of patients with migraine, especially adolescent and adult females, had history of psychogenic non-epileptic seizures during attacks of acute migraine. This appears to be the first report on these features in Indian subjects with migraine.

Effects of diazepam on125I-iomazenil-benzodiazepine receptor binding and epileptic seizures in the El mouse

To investigate changes in free benzodiazepine receptor density in response to repeated, long-term administration of diazepam in epilepsy, we assessed 125I-iomazenil (125I-IMZ) binding in a mouse model. El mice were divided into two groups of 12 mice each which received either no diazepam (E1(D[-]) group) or 2 mg/kg of diazepam per week (El(D[+]) group). Nine ddY mice were used as a control. Once each week from the age of 5 to 19 weeks, the El mice received stimulation to produce epileptic seizures 20 minutes after receiving intraperitoneal injections. At 20 weeks of age, a total dose of 0.37 MBq of 125I-IMZ was injected in all mice and their brains were rapidly removed 3 hours later. The incidence of epileptic seizures at the age of 19 weeks and the autoradiograms of the brain were compared. The incidence of epileptic seizures in response to weekly stimulation was significantly lower in the E1(D[+]) group than in the E1(D[-]) group (p < 0.001). The percent injected doses of 125I-IMZ per gram of tissue in the cortex, hippocampus and amygdala were significantly lower in the E1(D[+]) group than in the E1(D[-]) group (p < 0.05). The results suggest that diazepam binds competitively to 125I-IMZ as an agonist to free benzodiazepine receptor sites in the cortex, hippocampus and amygdala and shows anticonvulsant effect in E1 mice.

Does epilepsy influence the outcome of antireflux procedures in neurologically impaired children?

In neurologically impaired patients (NIP), surgical management of gastroesophageal reflux disease (GERD) has become a widespread standard. Several follow-up studies have shown a high incidence of complications and recurrent reflux. As one of the possible causes epilepsy is mentioned repeatedly in the literature. The aim of this study was to determine the effective impact of epilepsy on the postoperative outcome by comparing results of our patients suffering from epilepsy to those without this disorder. From 1984 to 1999, a total of 45 NIP underwent antireflux surgery, including 20 patients suffering from epilepsy (EP) and 25 patients without this disorder (nEP). The existence of epileptic disorders, incidence of epileptic seizures and administration of anticonvulsatory drugs as well as results of diagnostic procedures, postoperative complications and incidence and time of recurrence of pathologic GER were recorded and analysed retrospectively. Preoperatively all patients had pathologic results in 24 h pH-monitoring. Median RI was 15.75 (EP, range 5.2-28.6) and 17.55 (nEP; range 7.2-26.5). 12-months-postoperative 24 h pH-monitoring showed a median RI of 3.8 (EP; range 1.3-25.6) versus a median RI of 3.3 (nEP; range 0.7-26.3). During the long-term follow-up evaluation of 3.9 years, 17 EP suffered from persistent epileptic seizures despite medical treatment. 19 patients (42%) developed recurrent reflux. This included seven EP (35%) and 12 nEP (48%). The necessity of reoperation was higher in nEP (n = 5, 20%) than in EP (n = 1, 5%). This analysis did not show a significant correlation between recurrence of pathologic GER after fundoplication and the incidence of epileptic seizures. We consider our findings to strongly question the widespread opinion considering this correlation. We conclude, that cerebral seizures alone do not alter the operative outcome of antireflux surgery in NIP.

Epileptic seizures, cranial neuralgias and paroxysmal symptoms in remitting and progressive multiple sclerosis.

The occurrence of a first epileptic seizure, spinal or brainstem paroxysmal symptom and cranial neuralgia during 25 years after onset was studied in a population-based multiple sclerosis (MS) cohort of 255 patients. Epileptic seizures occurred in 20, paroxysmal symptoms in 11 and cranial (trigeminal, intermedius, retroauricular or occipital) neuralgia in 11 patients. The yearly incidence of epileptic seizures in MS was estimated to be 349(+/-153)/100,000, approximately seven times higher than in the general population. The yearly incidence of a first paroxysmal symptom in the present material was calculated to be 190 cases in 100,000 MS patients, and the yearly incidence of cranial neuralgia was 189 cases in 100,000 MS patients. The epileptic seizures were more frequent during the progressive course than in the relapsing-remitting (RR) course. The frequencies of paroxysmal symptoms and cranial neuralgia did not differ between these two disease courses. A coincidence of epileptic seizures and a decline in cognitive functioning not seen among patients with paroxysmal symptoms was found The relatively late occurrence of epileptic seizures indicates that the frequency of epileptogenesis, known to involve neuronal damage, increases in the later stages of MS.

Heritability of epileptic seizures in the Belgian tervueren.

Survey data were collected on the incidence of epileptic seizures in 997 Belgian tervuerens. The heritability of this disorder was estimated as 0.77 (with a 95 per cent confidence interval spanning from 0.65 to 0.88) using a Bayesian analysis in an ordered categorical threshold model. Single locus models do not appear adequate as an explanation for this inherited seizure disorder. The high heritability estimate suggests that breeders can wage a successful battle against this disorder by breeding unaffected individuals, particularly those from families with no history of seizures.

The Natural History of Dementia in Down's Syndrome

In a prospective longitudinal study with death as the end point in 17 middle-aged patients with Down's syndrome, dementia was clinically diagnosed in 15 patients, by means of careful observations in daily circumstances. Autopsies were performed in 10 cases: 8 demented patients and 2 nondemented patients. Neuropathologically, Alzheimer-type abnormalities were demonstrated in 9 patients, both demented and nondemented, and combined Alzheimer-type abnormalities with infarctions were demonstrated in 1 patient. In the 14 demented patients who did not show evidence of cerebrovascular or systemic vascular disease, dementia had an early onset and was rapidly progressive (mean age at onset, 51.3 years in the moderately retarded patients and 52.6 years in the severely retarded patients; mean duration of symptoms, respectively, 4.9 and 5.2 years). Cognitive and behavioral decline corresponded to symptoms of dementia of the Alzheimer's type in patients without Down's syndrome, but often were not recognized early. In the present group of patients, there was a remarkably high incidence of gait and speech deterioration. Also, the incidence of epileptic seizures and myoclonus was about eightfold, as compared with dementia of the Alzheimer's type in patients without Down's syndrome.

Clinical implications of benign epileptiform transients of sleep

One hundred electroencephalograms (EEGs) with benign epileptiform transients of sleep (BETS) were reviewed. The incidence of epileptic seizures, syncope, headaches, transient ischemic attacks (TIAs), dizziness and psychiatric complaints was determined. The incidence of these symptoms was similarly ascertained for another group of patients whose sleep EEGs had preceded (96 patients) or followed (96 patients) each of the BETS EEGs. These patients formed 2 separate internal control groups. No significant differences in the demographic composition of the 3 groups or in the incidence of symptoms or diagnoses were noted. The patients with BETS were also divided into 2 groups according to whether their EEGs were otherwise normal or abnormal. Each of these 2 groups was compared with their respective control group (pre- or post-BETS patients with normal or abnormal EEGs). No significant differences in the incidence of seizures were noted. Benign temporal epileptiform transients of sleep appear to be an occasional but clinically unimportant finding in sleep tracings.

Genetics of migraine and migraine accompagneé: a study of eighty-one children and their families.

Eighty-one patients suffering from childhood onset migraine and their families were investigated for familial prevalences of epileptic seizures and migraine. The incidence of epileptic seizures was not increased above the epidemiological risk. - In all, migraine is largely inherited from maternal ascendents, irrespective of the sex of the index case. Clinical subtypes of migraine ("non-focal migraine" and migraine accompagnée) are not accompanied by respectively increased familial prevalences. - Onset of migraine is earlier in patients with a higher familial impact. These findings are discussed in context with a proposed multifactorial pathogenesis of migraine.