Epilepsy research
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The clinical differentiation between stroke and seizure is usually straightforward but postictal neurological deficits can be mistaken for stroke in case no detailed medical history is available. Up to now, the imaging findings of Todd's paresis are not well described. ⋯ Extensive postictal perfusion changes must be discriminated from emerging stroke to avoid potentially harmful therapy like thrombolysis. Further investigations are warranted to clarify the role of cerebrovascular dysfunction in the pathophysiology of postictal paresis.
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Certain music has been shown to improve mental function, leading to what is known as the Mozart effect. This study measured the impact of Mozart's Sonata for two pianos in D major, K.448, on different epileptic foci of epileptiform discharge in Taiwanese children (n=58) with seizure disorders and investigated the characteristics of the musical stimulus presented that resulted in epileptiform discharge reduction. ⋯ These results suggest that listening to Mozart K.448 for two pianos reduced epileptiform discharges in children with epilepsy. This study suggests that it is possible to reduce the number of epileptiform discharges in some patients by optimizing the fundamental tones and minimizing the higher frequency harmonics.
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To evaluate diffusion tensor imaging (DTI) indices of (i) cortical tubers and (ii) normal-appearing subcortical white matter adjacent to cortical tubers within the epileptogenic zone and non-epileptogenic zone. ⋯ DTI changes in normal-appearing white matter within the epileptogenic zone could represent abnormal white matter related to MRI-occult dysplastic cortex or ictal/interictal activity.
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Lithium is still the mainstay in the treatment of affective disorders as a mood stabilizer. Lithium also shows some anticonvulsant properties. While the underlying mechanisms of action of lithium are not yet exactly understood, we used a model of clonic seizure induced by pentylenetetrazole (PTZ) in male NMRI mice to investigate whether the anticonvulsant effect of lithium is mediated via NO-cGMP pathway. ⋯ Whereas several doses of aminoguanidine [an inducible NOS inhibitor] (20, 50 and 100 mg/kg) failed to alter the anticonvulsant effect of lithium. Our findings demonstrated that nitric oxide-cyclic GMP pathway could be involved in the anticonvulsant properties of the lithium chloride. In addition, the role of constitutive NOS versus inducible NOS is prominent in this phenomenon.
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Direct brain stimulation is an emerging treatment of epilepsy especially in patients that are not candidates for epilepsy surgery. Several different approaches of brain stimulation in epilepsy have been developed: stimulation is applied to interrupt epileptic networks in subcortical structures or a stimulus is directly applied to the seizure onset zone. Scheduled stimulation targets mainly subcortical structures like the anterior thalamic nucleus or the centromedian nucleus of the thalamus. ⋯ An automated implanted device for seizures detection and stimulation has been developed and shown to be safe for human use. A large clinical trial is currently ongoing. In conclusion, the optimal target and mode of stimulation for the treatment of epilepsy remains under investigation and requires large and costly controlled trials.