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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neuropsychological evaluation contributes towards identification of a seizure focus through assessment of function. Tests sample widely among cognitive abilities, usually contrasting language and visuospatial competence. In patients with a temporal-lobe focus, evaluation of memory is crucial and ideally should comprise a variety of tasks tapping different aspects of learning and memory. As a means of predicting and preventing severe postoperative memory impairment, memory is further tested in many cases with the intracarotid sodium amytal (IAP) procedure; hippocampus will be spared in patients who fail IAP memory tests. Performance after temporal lobectomy on three basic memory tests was evaluated in patients who had failed pre-operative IAP memory tests compared to those who had passed. Those who had failed performed significantly worse, confirming fragility of memory function in cases who have been identified as at risk by the IAP procedure.
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PMID:Neuropsychological techniques in the identification of epileptic foci. 141 65

The intracarotid amobarbital sodium (Amytal) procedure (IAP) was performed for 46 patients with temporal lobe epilepsy (21 with left seizure foci; 25 with right seizure foci). After anteromedial temporal lobectomy, neuronal densities were established for hippocampal subfields CA1, CA2, and CA3; the hilum; and the dentate granule cell layer. Intracarotid amobarbital procedure memory results were related to CA3 neuronal loss only. Patients who did not demonstrate memory after injection contralateral to the seizure focus had significantly fewer cells in CA3 than patients who did. Additionally, a significant correlation was observed between the intracarotid amobarbital procedure memory examination raw score after injection contralateral to the seizure focus and CA3 cell density. Using chi 2 analysis, significant differences were documented in the frequency with which memory was demonstrated after injection contralateral to the seizure focus for groups of patients classified by degree of CA3 neuronal loss. This finding supports prior research showing subfield specificity in some memory processes.
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PMID:The neural substrate of memory impairment demonstrated by the intracarotid amobarbital procedure. 198 26

We examined the efficacy of a memory difference score (DS: right minus left hemisphere memory) during the Wada test (intracarotid amobarbital procedure, IAP) for predicting seizure laterality and postoperative seizure outcome in 70 left speech dominant patients from two epilepsy centers. DS > or = 2, after addition of 1 point to the left hemisphere injection score to account for aphasia, were noted in 71.4% of patients and correctly predicted surgery side for 98.0% of these patients. The DS related significantly to seizure outcome at 1-year follow-up (p < 0.002) and correctly predicted 80% of patients who were seizure-free. Patients whose DS did not correctly predict seizure laterality more frequently required invasive studies to establish seizure onset. The relationship of the DS to laterality did not differ significantly by class of IAP memory stimuli. When seizures originate from the temporal lobe, the IAP memory DS predicts seizure laterality by assessing the functional adequacy of the involved hemisphere and is predictive of seizure control.
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PMID:Wada memory disparities predict seizure laterality and postoperative seizure control. 764 24

This study discusses the results from the IAP and its lateralizing and prognostic value in patients with temporal lobe epilepsy (TLE) and mesial temporal sclerosis (MTS). Eighteen patients were submitted to the IAP. Fifteen had bitemporal and 3 unitemporal lobe epilepsies. All patients had MTS on MRI and in one there was an unrelated lesion in the contralateral hippocampus. Nine bitemporal patients passed after the injection ipsilateral to the MTS and 4 failed bilaterally. One bitemporal passed bilaterally. Seven of these bitemporal patients passed an injection ipsilateral to MTS and failed on contralateral injection. Two of the unitemporal lobe patients passed the ipsilateral injection and failed the contralateral one. One of the unitemporal lobe patients failed bilaterally the IAP. Overall, 56% of the group disclosed the pass ipsi-/fail contralateral pattern in the IAP. Eight patients were operated, are seizure free and had no additional memory deficit. Many patients with TLE were found to have the pass ipsi-/fail contralateral pattern in the IAP. This might prove to be of lateralizing and prognostic value in such cases.
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PMID:Results from the intracarotid amytal procedure in patients with uni or bitemporal lobe epilepsy and mesial sclerosis. 858 19

The effect of filling of the posterior cerebral artery (PCA) on memory performance during the intracarotid sodium amytal test (IAP) was investigated in 57 patients with unilateral temporal epileptic seizure foci under consideration for surgical therapy. Memory functioning was tested following injection of the internal carotid artery contralateral and ipsilateral to the side of seizure focus. In both cases, patients with PCA filling observed using conventional angiography showed a greater memory deficit, although this effect was more robust with contralateral injections. In a subsample of patients with left hemisphere dominance for language, the effect of PCA filling on memory performance was only significant when the right hemisphere was injected. The implications of these findings are discussed in terms of the validity of the IAP test and the different factors that need to be taken into account when interpreting IAP memory performance.
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PMID:Episodic memory dysfunction during sodium amytal testing of epileptic patients in relation to posterior cerebral artery perfusion. 892 94

In this study we investigated lateralized control of speech during the intracarotid amobarbital procedure. Vowel segments were extracted from recordings made during two separate amobarbital procedures and involving two patients. Subjects were right-handed, presented with focal left mesial temporal epileptogenic foci. Age of onset of seizure disorders was 1.5 years for one subject and 16 years for the other. Recorded pre- and postinjection speech samples were digitized. Analyses were conducted on formants 1 and 2 (F1, F2) measures to determine the extent of formant fluctuation in the time course of the IAP. Preliminary results showed, for these two cases, that the left hemisphere is involved in the control of both F1 and F2 and the right in the control of F2 only. The data reveal the potential of coupling the IAP procedure and the acoustical analysis of speech in the study of cerebral control of speech.
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PMID:Cerebral hemispheric control of speech during the intracarotid sodium amytal procedure: An acoustic exploration. 934 79

37 candidates for epilepsy surgery underwent the intracarotid amytal procedure (IAP; also known as the Wada test) to determine hemispheric speech dominance and memory capacity. 31 demonstrated left hemisphere speech dominance, 2 showed evidence for bilateral language and 4 demonstrated right hemispheric language dominance. Our study supports a correlational relationship between handedness, lesion laterality and age of onset of seizures, as reported in earlier studies. Left-handed patients with a left hemisphere lesion whose seizures began to an early age had a strong tendency for reversed language dominance. Asymmetry of at least 20% in performing the memory test was taken as the cutoff score for demonstrating laterality of lesions. The asymmetry score correctly predicted laterality of lesions in all 28 patients; 6 did not have asymmetry scores and 3 were examined for language only. None of the patients who successfully passed the Wada memory test had any significant postsurgical memory deficits; 1 had transient reduction in verbal memory and 4 who did not pass the test were not operated on for this reason. Our results demonstrate the importance of the Wada test in determining cerebral speech dominance, in predicting post-surgical amnesia, and support its usefulness in predicting laterality of seizure focus in candidates for temporal lobectomy.
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PMID:[Presurgical neuropsychological assessment in epilepsy: the Wada test]. 1088 55

Mocha (mh), a mouse model for Hermansky-Pudlak syndrome (HPS), is characterized by platelet storage pool deficiency, pigment dilution, and deafness as well as neurological abnormalities. The trans-Golgi/endosome adaptor-related complex AP-3 is missing in mh mice owing to a deletion in the gene encoding the delta subunit. Mice mutant for a second allele, mh(2J), are as hyperactive as mh, and display both spike wave absence and generalized tonic clonic seizures, but have less coat color dilution, no hearing loss, and no hypersynchronized EEG. Here we show that the mh(2J) mutation is due to an IAP element insertion in the Ap3d gene leading to a C-terminally truncated protein. Despite correct assembly of the AP-3 complex and localization to the trans-Golgi network and endosomes, AP-3 function in neurons remains impaired. While mh mice show a severe reduction of vesicular zinc (TIMM staining) owing to mislocalization and degradation of the Zinc transporter ZnT-3, the TIMM and ZnT-3 staining patterns in mh(2J) varies, with normal expression in hippocampal mossy fibers, but abnormal patterns in neocortex. These results indicate that the N-terminal portion of the delta subunit is sufficient for AP-3 complex assembly and subcellular localization to the TGN/endosomes, while subsequent function is regulated in part by cell-specific interactions with the C-terminal portion.
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PMID:Genetic and phenotypic analysis of the mouse mutant mh2J, an Ap3d allele caused by IAP element insertion. 1264 38

Sixteen phenethylamines are now included in Schedules I and II of the United Nations 1971 Convention on Psychotropic Substances. Most of the ring-substituted compounds are in Schedule I, whereas 2C-B, amphetamine, and methamphetamine are listed in Schedule II. Substances in Schedule IV (e.g. benzphetamine) are now regarded as obsolete pharmaceutical products. They all represent the 'old phenethylamines'. By 2013, nearly 100 illicit phenethylamines had been found in the European Union (EU). Of these, nine (MBDB, 4-MTA, PMMA, 2C-I, 2C-T-2, 2C-T-7, TMA-2, 5-IT and 4-MA) were submitted for risk assessment by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). All except MBDB were recommended for EU-wide control. Of the 'new phenethylamines', 2C-B was the most commonly reported, but other 2C compounds were widespread. Many of the ring-substituted phenethylamines are described in the 1991 book PIHKAL. Many fused ring phenethylamines have appeared in the past few years; they include further benzofurans (e.g. 5-and 6-APB), indanylalkylamines (e.g. 5-IAP), dibenzofurans (e.g. 2C-B-FLY) and 2-aminopropylindoles (e.g.5-IT). The recent and rapid rise of phenethylamines with bulky N-substituents (e.g. 25I-NBOMe) has been particularly significant. Although not phenethylamines, it is notable that the thiophene bioisosteres of amphetamine and methamphetamine as well as certain conformationally-restricted variants (e.g. aminoindanes) have been found in recent drug seizures. In the United Kingdom Misuse of Drugs Act, most ring-substituted phenethylamines are either listed by name or are covered by generic definitions dating from 1977. In 2013, temporary generic legislation included a number of benzofurans, indanylalkylamines and certain 'NBOMe' compounds.
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PMID:New phenethylamines in Europe. 2457 27

Absence epilepsy (AE) is a common type of genetic generalized epilepsy (GGE), particularly in children. AE and GGE are complex genetic diseases with few causal variants identified to date. Gria4 deficient mice provide a model of AE, one for which the common laboratory inbred strain C3H/HeJ (HeJ) harbors a natural IAP retrotransposon insertion in Gria4 that reduces its expression 8-fold. Between C3H and non-seizing strains such as C57BL/6, genetic modifiers alter disease severity. Even C3H substrains have surprising variation in the duration and incidence of spike-wave discharges (SWD), the characteristic electroencephalographic feature of absence seizures. Here we discovered extensive IAP retrotransposition in the C3H substrain, and identified a HeJ-private IAP in the Pcnxl2 gene, which encodes a putative multi-transmembrane protein of unknown function, resulting in decreased expression. By creating new Pcnxl2 frameshift alleles using TALEN mutagenesis, we show that Pcnxl2 deficiency is responsible for mitigating the seizure phenotype - making Pcnxl2 the first known modifier gene for absence seizures in any species. This finding gave us a handle on genetic complexity between strains, directing us to use another C3H substrain to map additional modifiers including validation of a Chr 15 locus that profoundly affects the severity of SWD episodes. Together these new findings expand our knowledge of how natural variation modulates seizures, and highlights the feasibility of characterizing and validating modifiers in mouse strains and substrains in the post-genome sequence era.
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PMID:Unraveling genetic modifiers in the gria4 mouse model of absence epilepsy. 2501 Apr 94


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