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1. |
Problems associated with Studies of Electrolyte Metabolism in Normal and Epileptogenic Cerebral Cortex |
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Epilepsia,
Volume 6,
Issue 3,
1965,
Page 183-197
D. B. TOWER,
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摘要:
SUMMARYThe general problems associated with investigations of fluid and electrolyte distribution and compartmentation in cerebral tissues have been discussed. Three specific aspects have been emphasized: (1) the variation of cortical fluid spacesin vivoas a function of species brain size; (2) the artifacts which may be introduced during preparation of samples for electron microscopy and hence may influence morphological interpretations of cortical fluid compartmentation; (3) the complexity and dynamic nature of fluid compartmentation in cortical samples incubatedin vitro.The importance of these aspects as factors contributing to current confusion in the field and their relevance to epileptogenic mechanisms are briefly considered.RÉASUMÉALes probleGmes geAneAraux associeAs aux recherches sur la distribution et le ‘compartimentage’ des liquides et eAlectrolytes dans les tissus ceAreAbraux sont discuteAs. Trois aspects speAcifiques sont mis en relief: (1) la variation des espaces liquidiens corticauxin vivoen fonction du volume du cerveau de l'espeGce consideAreAe; (2) les arteAfacts qui peuvent eCtre introduits pendant la preAparation des eAchantillons pour la microscopie eAlectronique et qui peuvent influencer les interpreAtations morphologiques du ‘compartimentage’ liquidien cortical; (3) la complexiteA et la nature dynamique du ‘compartimentage’ liquidien dans les eAchantillons corticaux incubeAsin vitro.L'importance de ces aspects en tant que facteurs contribuant aG la confusion des esprits dans ce domaine et leur rapport avec les meAcanismes eApileptogeGnes sont brieGveme
ISSN:0013-9580
DOI:10.1111/j.1528-1157.1965.tb03787.x
出版商:Blackwell Publishing Ltd
年代:1965
数据来源: WILEY
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2. |
Clinical Biochemistry of Epilepsy |
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Epilepsia,
Volume 6,
Issue 3,
1965,
Page 198-204
A. LOWENTHAL,
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摘要:
SUMMARYIn their totality, investigations on the clinical biochemistry of human epilepsy have not been conclusive and did not provide information useful for the diagnosis or treatment of this disease. There are good reasons to assume that the epileptic seizure is accompanied by disturbances in the metabolism of water, of some electrolytes, of fast‐moving globulins in the central nervous system and in the CSF and perhaps also of some amino‐acids. It is not possible, however, to specify these general assumptions. So far as myoclonus epilepsy is concerned, the possibility exists that further investigation into the metabolism of α2‐globulins may give a better understanding of this genetical condition.RÉASUMÉADans leur totaliteA, les recherches sur la biochimie clinique de l'eApilepsie humaine n'ont pas eAteA concluantes et n'ont pas fourni des renseignements utiles pour le diagnostic ou le traitement de cette affection. Il y a de bonnes raisons de supposer que la crise eApileptique est accompagneAe de troubles du meAtabolisme de l'eau, de quelques eAlectrolytes, des globulines qui migrent rapidement dans le systeGme nerveux central et dans le L.C.R. et, peut‐eCtre aussi, de quelques amino‐acides. II n'est pas possible cependant de preAciser ces hypotheGses geAneArales.En ce qui concerne l'eApilepsie myoclonique, il est possible qu'une recherche plus poussee dans le meAtabolisme des aL2‐globulines puisse donner une meilleure compreAhension de cette malad
ISSN:0013-9580
DOI:10.1111/j.1528-1157.1965.tb03788.x
出版商:Blackwell Publishing Ltd
年代:1965
数据来源: WILEY
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3. |
Allergy and Epilepsy |
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Epilepsia,
Volume 6,
Issue 3,
1965,
Page 205-216
H. STEVENS,
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摘要:
SUMMARYAs observed by Foster Kennedy 40 years ago, cases of allergic epilepsy are “dramatic and rare”. But perhaps less rare than he supposed, and now increasing for reasons outlined. A re‐examination of the role of allergy in epileptogenesis is currently warranted.Among the infinite causes of epilepsy, allergic reaction is one which under certain circumstances should be sought for. Laboratory tests may be helpful, but a comprehensive and carefully directed history is the most valid source of data.Some cases of late epilepsy will be found to be due to allergic epilepsy, represented by a single seizure only. But the severity of allergic reactions of the central nervous system varies through a broad range, and reflects a variety of neuropathological processes, some progressive and some even fatal. A condensed classification of possible clinical patterns is offered.These six cases again demonstrate the varied etiologies of epilepsy, and the need for the clinicians' relentless pursuit of possible causative or precipitating factors in the individual patient. They demonstrate also compelling reasons for an individualized therapeutic program. A stereotyped diagnostic or therapeutic approach to convulsive disorders is pre‐doomed to failure.RÉASUMÉAComme Foster Kennedy le faisait remarquer il y a 40 ans, les cas d'epilepsie allergique sont ‘rares et dramatiques’. Il est cependant possible qu'ils soient moins rares qu'on ne le suppose et peut‐eCtre meCme que leur freAquence augmente actuellement. Il est done justifieA d'envisager aG nouveau le roCle de l'allergie en matieGre d'eApilepsie.Parmi les causes infinies d'eApilepsie, la reAaction allergique est une de celles auxquel‐les il faut penser dans certaines circonstances. Les tests de laboratoire peuvent eCtre utiles en la matieGre, mais un interrogatoire compreAhensif et bien dirigeA demeure la source d'information la plus valide.Quelques cas d'eApilepsie tardive seront ainsi reconnus comme reAsultant d'une eApilepsie allergique repreAsenteAe par une crise unique. Mais la graviteA des reAactions allergiques du systeGme nerveux central varie treGs largement et reApond aG une grande varieAteA de processus neuropathologiques dont quelques uns sont progressifs et d'autres eAventuellement fatals. Une classification reAsumeAe des aspects cliniques possibles est preAsenteAe.Ces six cas fournissent aussi une preuve des eAtiologies varieAes de l'eApilepsie et de la neAcessiteA pour le clinicien de continuer aG rechercher les facteurs responsables et precipitants chez certains patients en particulier; ils deAmontrent encore la neAcessiteA d'un programme theArapeutique individualiseA. Une approche steAreAotypeAe du diagnostic et du traitement des manifestations convulsives serait en effet dest
ISSN:0013-9580
DOI:10.1111/j.1528-1157.1965.tb03789.x
出版商:Blackwell Publishing Ltd
年代:1965
数据来源: WILEY
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4. |
Auditory Clicks in Extinction of Stroboscope‐Induced Seizures |
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Epilepsia,
Volume 6,
Issue 3,
1965,
Page 217-225
F. M. FORSTER,
L. J. PTACEK,
W. G. PETERSON,
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摘要:
SUMMARYA patient with photic induced epilepsy was given extinction trials using the differential light intensity technique. This did not afford significant clinical improvement. The light extinction was coupled to sound stimuli and this proved feasible, special hearing aid eye‐glasses were modified and adapted so that intermittent light stimuli occurring in the environment produced sound stimuli. Extinction studies using these glasses significantly decreased the patient's seizures.RÉASUMÉAUn patient souffrant d'eApilepsie photo‐induite fut soumis, sans succeGs, aG une proceAdure d'extinction utilisant une technique d'intensiteA lumineuse diffeArencielle. Devant cet eAchec, l'extinction par la lumieGre fut coupleAe aG des stimuli auditifs et le sujet porta des lunettes ameAnageAes de telle sorte qu'une lumieGre intermittente survenant dans son environnement provoquait une stimulation sonore. Les eAtudes d'extinction effectueAes avec l'aide de ces lunettes montreGrent une reAduction significative des crises de ce
ISSN:0013-9580
DOI:10.1111/j.1528-1157.1965.tb03790.x
出版商:Blackwell Publishing Ltd
年代:1965
数据来源: WILEY
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5. |
Cyclical Spike Driving in Chronically Isolated Cortex |
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Epilepsia,
Volume 6,
Issue 3,
1965,
Page 226-242
D. A. PRINCE,
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摘要:
SUMMARYChronic cortical isolations were prepared in 12 cats and the effects of direct cortical stimulation on a penicillin epileptogenic focus in each slab were evaluated. Trains of low frequency stimuli (0.5–2.0/sec) could trigger spikes in all preparations. In 9 experiments when such stimulation was continued over many minutes it induced “cyclical spike driving” in the focus,i.e.trains of DCR‐spike complexes alternated with trains of simple DCR's. Cycles were remarkably regular and of long duration. This pattern of periodic activity responded in a predictable fashion to small changes in stimulus intensity, frequency and regularity. Characteristic latency changes between stimulus and triggered spike were seen in all prepartions with cyclical spike driving. The variations in SP level which occur during the cycles appeared to result from the spike activity and did not lead to the changes in spike triggering. Evidence is presented which suggests that the spike itself initiates a process with a long time constant which in turn acts to limit spike generation. These data may be relevant to the general problem of the limitation and control of cortical seizure discharges.RÉASUMÉADes cortex isoleAs chroniques ont eAteA preApareAs chez 12 chats et les effets d'une stimulation corticale directe sur un foyer eApileptique aG la peAnicilline ont eAteA eAvalueAs pour chaque lambeau. Des trains de stimuli aG basse freAquence (0.5—2.0/sec.) pouvaient deAclencher des pointes dans toutes les preAparations. Dans 9 expeAriences, lorsqu'une telle stimulation a eAteA continueAe au cours de nombreuses minutes, elle a provoqueA un “deAclenchement cyclique de pointes” dans le foyer, c'est aG dire des trains de complexes de pointes “DCR” alterneAs avec des complexes de simples “DCR's”. Les cycles eAtaient remarquablement reAguliers et de longue dureAe. Ce “pattern” d'activiteA reApondait d'une manieGre preAvisible aG de petites modifications de l'intensiteA, de la freAquence et de la reAgulariteA du stimulus. Des changements de latence caracteAristiques entre le stimulus et la pointe deAclencheAe ont eAteA observeAs dans toutes les preAparations avec deAclenchement cyclique des pointes. Les variations du niveau “SP” qui se produisent pendant les cycles apparaissent eCtre le reAsultat de l'activiteA de pointes. Ces constatations suggeGrent que la pointe elle‐meCme engendre un processus avec une longue constante de temps qui, aG son tour, agit pour limiter l'engendrement de la pointe. Ces donneAes peuvent se rapporter au probleGme geAneAral de la limitation et du controCle de
ISSN:0013-9580
DOI:10.1111/j.1528-1157.1965.tb03791.x
出版商:Blackwell Publishing Ltd
年代:1965
数据来源: WILEY
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6. |
Effects of Convulsions and Anticonvulsants on Blood Sugar in Rabbits |
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Epilepsia,
Volume 6,
Issue 3,
1965,
Page 243-249
N. R. BELTON,
J. E. ETHERIDGE,
J. G. MILLICHAP,
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摘要:
SUMMARYConvulsions induced by electroshock in rabbits were followed by an elevation in the blood sugar which was related directly to the strength of the current stimulus and the severity of the seizure. Phenobarbital prevented the convulsion and the blood sugar elevation after electroshock. The administration of diphenylhydantoin or gallamine was followed by a significant rise in blood sugar, and a further significant rise followed electroshock despite the absence of a convulsive response. It is concluded that the blood sugar elevation which follows an electroshock stimulus is unrelated to convulsive movementsper seand may be explained by central nervous excitation and stimulation of the sympathetico‐adrenal system.RÉASUMÉALes convulsions provoqueAes par l'eAlectrochoc chez le lapin sont suivies d'une eAleAvation du sucre sanguin que est directement relieAe aG la force du courant utiliseA comme stimulus et aG l'importance de la crise. Le pheAnobarbital preAvient les convulsions et l'eAleAvation de la glyceAmie apreGs eAlectrochoc. L'administration de dipheAnylhydantoine ou de gallamine entraine une eAleAvation significative du sucre sanguin qui est encore eAleAve de facLon aussi significative apreGs un eAlectrochoc qui ne procure cependant pas de convulsions. Les auteurs concluent que l'eAleAvation du sucre sanguin qui suit un eAlectrochoc n'est pas lieAe aux mouvements convulsifs et peut eCtre expliqueAe par une excitation nerveuse centrale et une stimulation du systeme sympathico‐adreAner
ISSN:0013-9580
DOI:10.1111/j.1528-1157.1965.tb03792.x
出版商:Blackwell Publishing Ltd
年代:1965
数据来源: WILEY
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7. |
Petit Mai Status (“Spike‐Wave Stupor”)An electro‐clinical appraisal |
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Epilepsia,
Volume 6,
Issue 3,
1965,
Page 250-262
E. NIEDERMEYER,
R. KHALIFEH,
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摘要:
SUMMARYIn 6 patients, almost continuous spike‐wave activity was seen in conjunction with stuporous episodes, lasting mostly one or two days. Three of these patients were adults, two were teen‐agers and one patient was 5 years old. Most of these patients were followed up for a considerable length of time.In addition to these twilight states, all of the patients had grand mal convulsions and at least 2 suffered also from petit mal lapses. Neurological and neuroradiological findings were essentially normal. There was impairment of mental functions in the majority of our patients. The etiology was unknown in 4 cases; one patient had chronic otitis in childhood; in another patient, there was evidence of childhood encephalitis.The diagnosis of petit mal status is based upon the EEG which shows generalized and fairly continuous spike‐wave activity during the ictal episode. These spike‐wave complexes are frequently atypical rather than classical. In the interval, the EEG shows a much lesser amount of paroxysmal activity or even no spiking at all.The term “petit mal status” is confusing and should be abandoned. A few of the earlier investigators described prolonged petit mal attacks or petit mal in rapid succession rather than episodic twilight status. Terms as “ictal stupor” or “spike‐wave stupor” appear to be more appropriate.The differential diagnosis should rule out inter‐ictal epileptic psychosis and prolonged psychomotor automatism.Triggering and inhibitory factors may be present; one of our cases showed immediate blocking or paroxysmal activity to visual stimuli (limited to contour vision).In our material, the response to medication was fair to poor; none of the better known anti‐convulsants was particularly successful; tridione seemed to be more effective than other drugs.It is felt that “spike‐wave stupor” constitutes a “centrencephalic” epileptic manifestation. Its pathophysiology, however, is still obscure.RÉASUMÉAChez 6 malades, on a observeA une activiteA E.E.G. avec pointe—ondes presque continus associeAe aG des eApisodes stuporeux, durant le plus souvent un aG deux jours. Trois d'entre eux eAtaient adultes, deux adolescents et un aCgeA de 5 ans. La plupart de ces malades ont eAteA suivis pendant un temps prolongeA.En plus de ces eAtats creApusculaires, tous ces sujets avaient des crises grand mal, et au moins deux preAsentaient eAgalement des absences petit mal. Les examens neurologiques et neuroradiologiques eAtaient normaux. La majoriteA de nos malades preAsentait une alteAration des fonctions mentales. L'eAtiologie eAtait inconnue dans 4 cas; un sujet avait eu une otite chronique dans l'enfance; chez un autre il y avait eu une enceAphalite dans l'enfance.Le diagnostic d'eAtat de petit mal est baseA sur l'E.E.G., qui montre durant l'eApisode critique une deAcharge geAneAraliseAe et vraiment continue de pointe—ondes. Ces complexes pointe—ondes eAtaient plus freAquemment atypiques que classiques. Dans l'intervalle, l'E.E.G. montrait des deAcharges en beaucoup moins grand nombre ou meCme plus aucune deAcharge.Le terme de ‘petit mal status’ preCte aG confusion et doit eCtre abandonneA. Un certain nombre des premieGres descriptions concerne des acceGs de petit mal prolongeAs ou reApeAteAs de facLon rapprocheAe, plutoCt que des eAtats creApusculaires eApisodiques. Le terme de ‘stupeur critique’ ou de ‘stupeur avec pointe—onde’ apparaiCt plus approprieA.Le diagnostic diffeArentiel doit eAliminer les psychoses eApileptiques intercritiques et les automatismes psychomoteurs prolongeAs.Des facteurs activateurs ou inhibiteurs peuvent eCtre retrouveAs: un de nos cas preAsentait un blocage immeAdiat ou bien une deAcharge paroxystique sous l'influence de stimuli visuels.Dans nos cas les reAsultats de la theArapeutique ont eAteA assez bons jusqu'aG mauvais; aucun des meilleurs anti‐convulsivants connus n'eAtait particulieGrement efficace; la tridione semblait eCtre plus active que les autres meAdicaments.L'on pense que la ‘stupeur avec pointe‐onde’ est une manifestation eApileptique ‘centren
ISSN:0013-9580
DOI:10.1111/j.1528-1157.1965.tb03793.x
出版商:Blackwell Publishing Ltd
年代:1965
数据来源: WILEY
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8. |
Changes in MMPI Scale Scores and an Index of Psychopathology following Unilateral Temporal Lobectomy for Epilepsy |
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Epilepsia,
Volume 6,
Issue 3,
1965,
Page 263-273
M. J. MEIER,
L. A. FRENCH,
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摘要:
SUMMARYThe direction and extent of change in personality functioning, as measured by the Minnesota Multiphasic Personality Inventory (MMPI), were investigated longitudinally before and one year or more following unilateral temporal lobectomy for intractable psychomotor seizures. Although the pre‐ to postoperative changes were not sufficiently profound to postulate a major reorganization of personality functioning in these patients, selected scale scores consistently were observed to decline in the less psychopathological direction, especially on test measures for which schizoadaptive behavioral correlates have been established in psychiatric populations. These reductions were not conspicuously different after left as compared to right temporal lobectomy. However, the presence of bilateral preoperative EEG abnormalities was associated with higher initial MMPI scale elevations and greater scale score declines postoperatively. This was especially prevalent among patients with independent bitemporal EEG spike foci preoperatively.RÉASUMÉALa direction et l'eAtendue des changements de la personnaliteA, aG l'aide de l'Inventaire de PersonnaliteA Multiphasique Minnesota (MMPI), ont ete explorees longitudinale‐ment avant et un an ou davantage apreGs lobotomie temporale unilateArale pour crises psychomotrices rebelles. Quoique les changements de la personnaliteA de ces patients, entre les peAriodes preA‐ et post‐opeAratoires, ne soient pas suffisamment profonds pour postuler une reAorganisation majeure de la personnaliteA, on observe que les scores de certaines eAchelles baissent de facLon constante dans une direction indiquant des troubles psychopathologiques moindres. Cet abaissement concerne plus particulieGrement les eAchelles pour lesquelles des correAlations avec le comportement schizoiUde ont eAteA eAtablies dans des populations psychiatriques. Ces modifications ne sont pas sensiblement diffeArentes apreGs lobotomie temporale droite ou gauche. Par contre, la preAsence d'anomalies eAlectroenceAphalographiques bilateArales sur l'E.E.G. avant intervention s'est trouveAe associeAe, d'une part, aux plus hauts scores initiaux du MMPI et, d'autre part, aux plus grandes diminutions apreGs l'opeAration. Ceci est particulieArement eAvident parmi les patients preAsentant aG l'E.E.G., avant intervention, des foyers de pointes bitemporales inde
ISSN:0013-9580
DOI:10.1111/j.1528-1157.1965.tb03794.x
出版商:Blackwell Publishing Ltd
年代:1965
数据来源: WILEY
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9. |
Announcement |
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Epilepsia,
Volume 6,
Issue 3,
1965,
Page 274-274
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ISSN:0013-9580
DOI:10.1111/j.1528-1157.1965.tb03795.x
出版商:Blackwell Publishing Ltd
年代:1965
数据来源: WILEY
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