摘要:

Summary:The cerebellum is electrically and metaboli cally active during seizures. Numerous studies have also shown that cerebellar electrical stimulation and lesions of the cerebellar cortex or nuclei influence seizure thresh old, but there are significant contradictions, with different effects observed even in investigations using the same species and similar seizure types and experimental ma nipulations. Discrete intracerebral microinjection of neu roactive agents has been used to characterize the way in which other brain regions control seizures, but has not been applied to the cerebellar systems. This approach has advantages because effects are restricted to specific re ceptors and spare passing axons; experimental variables also can be simply specified and reproduced. We used this method to characterize the role of the cerebellar nu clei in seizures and to determine if observed effects could be reproduced with different agents at different doses. Effects of bilateral control microinjections in the fastigial (medial) cerebellar nucleus were compared with different doses of the GABAAagonist piperidine‐4‐sulfonic acid and the GABABagonist (−)baclofen (Bf). Soon after in jection, the animals were ataxic. After 4 min, seizures were induced by timed continuous intravenous (i.v.) bicu culline (BIC) infusion. Both GABA agonists produced significant reductions in myoclonic, clonic, and tonic sei zure thresholds. Injections just dorsal or anterior to this nucleus and bilateral dentate (lateral) nucleus injections had little effect on seizures. These results demonstrate that the cerebellar system does control seizures, but does not provide support for the early concept that cerebellar stimulation and systemic phenytoin block seizures through inhibition of cerebellar nuclei secondary to Pur kinje cell activ

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1993.tb02121.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary:The influence of audiogenic seizures (AGS) on synaptic facilitation was studied in DBA/2J (D2) and C57BL/6J (B6) mice. AGS susceptibility is inherited in D2 mice, but can be acquired in AGS‐resistant B6 mice through acoustic priming. The experiments were per formed on hippocampal slices obtained from D2 and B6 mice both with and without seizures. Long‐term potenti ation (LTP) and low‐Mg2 +‐induced synaptic facilitation (LMISF) were evaluated after stimulation of Schaffer col laterals. The magnitude of LTP and LMISF was signifi cantly greater in slices obtained from mice with seizures than from mice without seizures in both strains. Seizure induced enhancement of LTP and LMISF was markedly reduced by the JV‐methyl‐D‐aspartate (NMDA) receptor antagonist AP‐5. The noncompetitive NMDA receptor antagonist MK 801 reduced the efficiency of priming in B6 mice and abolished AGS in D2 mice and primed B6 mice, the data suggest that audiogenic seizures can en hance synaptic facilitation through activation of th

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1993.tb02122.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary:We used the pilocarpine model of chronic spontaneous recurrent seizures to evaluate the time course of supragranular dentate sprouting and to assess the relation between several changes that occur in epilep tic tissue with different behavioral manifestations of this experimental model of temporal lobe epilepsy. Pilo carpine‐induced status epilepticus (SE) invariably led to cell loss in the hilus of the dentate gyrus (DG) and to spontaneous recurrent seizures. Cell loss was often also noted in the DG and in hippocampal subfields CA1 and CA3. The seizures began to appear at a mean of 15 days after SE induction (silent period), recurred at variable frequencies for each animal, and lasted for as long as the animals were allowed to survive (325 days). The granule cell layer of the DG was dispersed in epileptic animals, and neo‐Timm stains showed supra‐and intragranular mossy fiber sprouting. Supragranular mossy fiber sprout ing and dentate granule cell dispersion began to appear early after SE (as early as 4 and 9 days, respectively) and reached a plateau by 100 days. Animals with a greater degree of cell loss in hippocampal field CAS showed later onset of chronic epilepsy (r= 0.83, p<0.0005), suggest ing that CA3 represents one of the routes for seizure spread. These results demonstrate that the pilocarpine model of chronic seizures replicates several of the fea tures of human temporal lobe epilepsy (hippocampal cell loss, suprar and intragranular mossy fiber sprouting, den tate granule cell dispersion, spontaneous recurrent sei zures) and that it may be a useful model for studying this human condition. The results also suggest that even though a certain amount of cell loss in specific areas may be essential for chronic seizures to occur, excessive cell loss may hinder epileptoge

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1993.tb02123.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary:The effect of domoic acid‐induced seizure activity on energy metabolism and on brain pH in mice was studied by continuous EEC recording and in vivo31P nuclear magnetic resonance (NMR) spectroscopy. Mice were divided into ventilated (n = 6) and nonventilated (n = 7) groups. Baseline EEG was 0.1‐mV amplitude with frequence of>30‐Hz and of 4–5 Hz. After intraperitoneal (i.p.) administration of domoic acid (6 mg/kg), electro graphic spikes appeared at increasing frequency, pro gressing to high‐amplitude (0.1‐0.8 mV) continuous sei zure activity (status epilepticus). In ventilated mice, the [31P]NMR spectra showed that high‐energy phosphate levels and tissue pH did not change after domoic acid administration or during the intervals of spiking or status epilepticus. Nonventilated mice showed periods of EEG suppression accompanied by decreases in the levels of high‐energy phosphate metabolites and in pH, corresponding to episodic respiratory suppression during the spiking interval. In all animals, status epilepticus was fol lowed by a marked decrease in EEG amplitude that pro gressed rapidly to isoelectric silence. [31P]NMR spectra obtained after this were indicative of total energy failure and tissue acidosis. In a separate group of ventilated mice (n = 4), domoic acid‐induced status epilepticus was ac companied initially by an increase in mean arterial blood pressure (MAP) that slowly returned to baseline level. Isoelectric silence was accompanied by a decrease in MAP to 75 ± 8 mm Hg. These experiments suggest that domoic acid‐induced seizures are not accompanied by an increase in substrate demand

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1993.tb02124.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary:The convulsant effects of a high (5 mg/kg intraperitoneally, i.p.) dose of benzodiazepine (BZD) receptor ligand methyl β‐carboline‐3‐carboxylate (β‐CCM), whether or not preceded by administration of two lower doses of β‐CCM (0.5 and 1 mg/kg i.p.) or of saline were studied in nine inbred mouse strains. In five of the strains (A/J, BALB/cBy, C3H/HeJ, CBA/H, and DBA/2J), neither saline nor preceding injections of β‐CCM had any effect on subsequent reactivity to the subsequent convulsant dose. In the other 4 strains, such injections induced either tolerance (CPB‐K, NZB), or sensitization (C57BL/6J, XLII), whatever the compound subsequently administered (β‐CCM or saline). In these strains, the data rule out any tolerance or sensitization effect due to β‐CCM, but suggest that such effects could be

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1993.tb02125.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary:The traditional view that epilepsy is usually a chronic condition in which the prognosis is consistently poor has been challenged in the last 2 decades. Evidence from population‐based studies and from intervention studies in newly diagnosed patients has produced a wealth of information of a much better prognosis. It is now generally accepted that as many as 70–80% of people developing seizures for the first time will eventually achieve terminal remission, whereas the remaining 20–30% will continue to have recurrent seizures despite all treatment. Despite the high recurrence rate after a first epileptic seizure, remission usually occurs early and for most persons, epilepsy is a short‐lived condition. The exact role of antiepileptic drugs (AEDs) in this good outcome, however, remains open to debate, because the natural history of the untreated condition is largely unknown. In this article, factors that may influence the prognosis of the epilepsies, including the problems of diagnosis, are reviewed. Special emphasis is given to the issue of spontaneous remission and the question of prognosis of different epileptic sy

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1993.tb02126.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary:Before a health education program can be established, one must first know what the target population believes and does with respect to the disease in question. Therefore, we performed a study among Tanzanian rural inhabitants to identify their knowledge, attitude, and practice (KAP) toward epilepsy: 3,256 heads of households (mean age 40.2 years, range 15–90 years; M/F ratio 1:1) were interviewed. Of the respondents, 32.9% said they had never seen a seizure; 67.7% said they did not know the cause of epilepsy; 33.3% mentioned various causes including heredity, witchcraft, infection of the spinal cord, hernia; 40.6% believed epilepsy was infectious through physical contact, flatus, breath, excretions, sharing food; 36.8% believed epilepsy could not be cured and 17.1% believed it could not even be controlled; 45.3% believed epilepsy could be treated by traditional healers, and only 50.8% believed hospital drugs were of any use; and 62.7% of the respondents would not allow an epileptic child to go to school for various reasons, including mental subnormality (54.0%), fear of the child falling while alone (65.9%), and fear that the epileptic child would infect other children (11.2%). Concerning what is to be done when a seizure occurs, 33.5% of the respondents would keep away and not touch the person; 16.5% would take some potentially harmful measure such as forcing a mouth gag or forcing a drink such as water (1 even mentioned urine); 5.2% would take unnecessary measures such as rushing the patient to a hospital. Only 35.7% of respondents would perform at least some of the currently recommended first‐aid measures. Therefore, there is a need for health education on epilepsy in Tanzania, and these results are forming the base for design and execution of a health education and a primary health care program in epilepsy cont

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1993.tb02127.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary:Epilepsy secondary to active or inactive neurocysticercosis (NCC) is a major public health problem in Latin American countries. In an open‐label pilot trial, we evaluated and followed (mean = 13 months) 16 patients with epilepsy resulting from active NCC which was treated with anticisticercal (ACC) drugs. These patients were aged 12–68 years with confirmed active NCC and seizures not controlled by adequate antiepileptic drug (AED) therapy. Patients were treated with albendazole or praziquantel (ALB and PZQ, ACC drugs) and AED monotherapy. The number of NCC cysts was markedly reduced by ACC therapy. Thirteen patients remained seizure‐free and 2 had only one seizure during follow‐up. Our data suggest a positive effect of ACC treatment on the prognosis of epilepsy caused by active NCC, but a prospective, double‐blind, controlled study with long‐term follow‐up must be performed to determine whether ACC therapy improves long‐term

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1993.tb02128.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary:A door‐to‐door survey was made in Kelibia, Tunisia to determine the prevalence of major neurologic disorders, including epilepsy. The survey was made according to a World Health Organization (WHO) protocol (1981). All individuals responding positively to the screening tool were examined by a neurologic team using well‐defined diagnostic criteria. One hundred forty‐one individuals, alive on prevalence day (July 1, 1985), were identified as having active epilepsy, giving a crude prevalence ratio of 4.04 per 1,000 and an age‐adjusted (on WHO population) prevalence ratio of 3.64 per 1,000. Prevalence ratios increase with age (in children and young adults with the highest prevalence ratio at ∼20 years) and decrease after 40 years. The most frequently identified type was generalized convulsive seizures (93%). The most frequently associated conditions were cerebral palsy and mental

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1993.tb02129.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary:We reviewed the case records of 249 adult patients with generalized convulsive status epilepticus (SE) examined at San Francisco General Hospital between 1977 and 1989 and identified 27 patients (10.8%) in whom alcohol abuse was the only identifiable precipitating cause of SE. In 12 patients (44% of the study group), SE was the first presentation of alcohol‐related seizures. Seizures with focal features were observed in 11 patients (40.1%), but there was little correlation with localized computed tomography (CT) or EEG abnormalities. SE was controlled with phenytoin (PHT), with or without a benzodiazepine (BZD), in 18 patients (66.7%). Twentytwo patients (81.5%) were discharged with no new neurologic deficits, but time to recovery of baseline mental status was prolonged (>12 h) in 24 patients. With regard to alcohol abuse history, study patients did not differ from a comparison group with isolated alcohol withdrawal seizures. The results indicate that alcohol abuse is a common cause of SE and that SE may be the first presentation of alcohol‐related seizures. Furthermore, the outcome of patients with alcohol‐related SE compares favorably with that of patients with SE due to other causes, but recovery of these patients may be complicated by a prolonged postictal

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1993.tb02130.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY