Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014547 (focal epilepsy)
 1,627 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 40-60% of cases with interictal activity in EEG, fMRI cannot locate any focus or foci with simultaneous EEG/fMRI. In experimental focal epilepsy, a priori knowledge exists of the location of the epileptogenic area. This study aimed to develop and to test an experimental focal epilepsy model, which includes dynamic induction of epileptic activity, simultaneous EEG/fMRI, and deep anesthesia. Reported results are from seven pigs (23 +/- 2 kg) studied under isoflurane anesthesia (1.2-1.6 MAC, burst-suppression EEG) and muscle relaxant. Hypo- and hypercapnia were tested in one pig. Penicillin (6000 IU) was injected via a plastic catheter (inserted into the somatosensory cortex) during fMRI (GRE-EPI, TE = 40 ms, 300 ms/two slices, acquisition delay 1700 ms) in 1.5 T (N = 6). Epileptic spikes between acquisition artifacts were reviewed and EEG total power calculated. Cross-correlation between voxel time series and three model functions resembling induced spike activity were tested. Activation map averages were calculated. Development of penicillin induced focal epileptic activity was associated with linear increase and saturation up to approximately 10-20%, in BOLD activation map average. Its initial linear increase reached 2.5-10% at the appearance of the first distinguished spike in ipsilateral EEG in all six animals. Correlated voxels were located mainly in the vicinity of the penicillin injection site and midline, but few in the thalamus. In conclusion, development of focal epileptic activity can be detected as a BOLD signal change, even preceding the spike activity in scalp EEG. This experimental model contains potential for development and testing different localization methods and revealing the characteristic time sequence of epileptic activity with fMRI during deep anesthesia.
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PMID:BOLD signal increase preceeds EEG spike activity--a dynamic penicillin induced focal epilepsy in deep anesthesia. 1600 47

Epilepsy is the fourth most common neurologic disorde in the United States, affecting over 2.2 million people. Epilepsy is associated with a number of medical and psychiatric comorbidities, higher health-care use and cost, and substantial economic burden. OSA is twofold more common in adults with epilepsy than in age-matched control subjects, and the incidence increases with age. Self-reported daytime sleepiness is not helpful in predicting OSA, possibly related to the ceiling effect of general sleepiness among people with epilepsy from diverse causes. Mostly small retrospective series found a significant reduction in seizures in people with epilepsy and OSA adherent with positive airway pressure therapy compared with untreated individuals. This finding illustrates the potential beneficial effects of sleep therapies on epilepsy. Central apnea, oxygen desaturations, and hypercapnia can occur during the ictal and immediate postictal period, especially with generalized tonic-clonic seizures. Central apneas have been produced by electrical stimulation of mesial temporal structures. These respiratory disturbances suggest activation of the central autonomic network and may contribute to sudden unexpected death in epilepsy (SUDEP), the leading cause of epilepsy-related death in people with drug-resistant epilepsy. SUDEP typically occurs during sleep, and patients are more often found in a prone position and have a history of nocturnal seizures. Whether OSA contributes to SUDEP is unknown. Vagus nerve stimulation is a form of neuromodulation for drug-resistant focal epilepsy. When the device activates during sleep it causes reduction in airflow and respiratory effort, airflow obstruction, and oxygen desaturations, sometimes producing a clinical sleep apnea syndrome. The goal of this review is to discuss firmly established and recently recognized clinical, neurobiologic, electrophysiologic, and polysomnographic relationships between sleep-disordered breathing and epilepsy.
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PMID:Epilepsy and Sleep-Related Breathing Disturbances. 3071 81