Epilepsy and tobacco smoking: a cross-sectional study.

There is little data concerning the prevalence of smoking in the population of people with epilepsy. The present study addresses this aspect in a sample of 429 unselected adults with epilepsy living in French-speaking Switzerland. The criterion of at least one cigarette per day for the past 6 months was used to define the status of "current" smoker.

Asymmetric POSTS associated with unilateral EEG abnormalities.

Objective: Positive occipital sharp transient of the sleep (POSTS) are considered a normal variant of non-REM sleep EEG. We describe a small series of patients with asymmetric POSTS and ipsilateral abnormal EEG findings.

Methods: Over a period of 30 weeks, we prospectively observed five consecutive subjects with strictly unilateral POSTS associated with ispilateral electrographic abnormalities.

Psychiatric comorbidity in patients evaluated for chronic epilepsy: a differential role of the right hemisphere?

Introduction: Psychiatric disorders are known to occur frequently in chronic epilepsy. The aim of this study is to investigate the prevalence of psychiatric comorbidity and its relationship to regional cerebral dysfunction in patients admitted to a tertiary epilepsy center for epilepsy surgery.

Methods: 217 patients were investigated.

Ictal bradycardia and asystole: an uncommon cause of syncope.

We report on two patients with recurrent syncope secondary to ictal bradyarrhythmias, triggered by partial epileptic seizures with atypical, stereotyped auras. Ictal bradyarrhythmias are potentially lethal, and likely originate from the involvement of limbic autonomic regions. The appropriate treatment is double-headed, including an antiepileptic drug and the implantation of a pacemaker.

The application of infrared chemical imaging to the detection and enhancement of latent fingerprints: method optimization and further findings.

Fourier transform infrared (FTIR) chemical imaging allows the collection of fingerprint images from backgrounds that have traditionally posed problems for conventional fingerprint detection methods. In this work, the suitability of this technique for the imaging of fingerprints on a wider range of difficult surfaces (including polymer banknotes, various types of paper, and aluminum drink cans) has been tested. For each new surface, a systematic methodology was employed to optimize settings such as spectral resolution, number of scans, and pixel aggregation in order to reduce collection time and file-size without compromising spatial resolution and the quality of the final fingerprint image.

Status epilepticus: an independent outcome predictor after cerebral anoxia.

Background: Prognosis of status epilepticus (SE) depends on its cause, but there is uncertainty as to whether SE represents an independent outcome predictor for a given etiology. Cerebral anoxia is a relatively homogenous severe encephalopathy. Postanoxic SE is associated to a nearly 100% mortality in this setting; however, it is still unclear whether this is a severity marker of the underlying encephalopathy, or an independent factor influencing outcome.

Post-ictal fever: a rare symptom of partial seizures.

Although fever may induce seizures, especially in children, its occurrence following epileptic spells has been rarely described, except from generalized convulsive status epilepticus. We present two patients suffering from focal seizures accompanied by episodes of post-ictal fever, and review similar reports in the literature of the last 40 years. Temperature changes following non-convulsive seizures might be induced by gene upregulation occurring in the hypothalamus, the nucleus tractus solitarius, or in other brain regions, producing a local inflammatory response.

Continuous assessment of electrical epileptic activity in acute stroke.

Objective: To determine the incidence and risk factors of electrical seizures and other electrical epileptic activity using continuous EEG (cEEG) in patients with acute stroke.

Methods: One hundred consecutive patients with acute stroke admitted to our stroke unit underwent cEEG using 10 electrodes. In addition to electrical seizures, repetitive focal sharp waves (RSHWs), repetitive focal spikes (RSPs), and periodic lateralized epileptic discharges (PLEDs) were recorded.

[Status epilepticus and neuronal degeneration: of circuitries and vicious circles].

The relationship between status epilepticus (SE) and neuronal degeneration is quite complex and difficult to investigate. Animal studies suggest that SE induces a progressive neuronal death; however, clinical observations on humans are less uniform: generalized SE may precede the development of hippocampal sclerosis, but other forms (such as simple-partial or complex-partial) seem less ominous. On the other side, SE can be encountered in many patients with neurodegenerative disorders, particularly those with severe forms.

Levetiracetam in a broad population of patients with refractory epilepsy: interim results of the international SKATE trial.

Objective: To prospectively assess the safety and efficacy of levetiracetam in patients with uncontrolled focal epilepsy, in a common practice-based setting.

Patients And Methods: In this phase IV, open-label, 16-week community-based study, adult patients with focal seizures initially received levetiracetam 1,000 mg/day. Throughout the study, the dose was adjusted in increments of 1,000 mg (maximum 3,000 mg/day) to achieve seizure control and maintain tolerability.

Subcortical nuclei volumetry in idiopathic generalized epilepsy.

Purpose: The exact anatomic and neurophysiologic correlates of idiopathic generalized epilepsy (IGE) in humans are still not well understood, although the thalamus has frequently been invoked as the crucial structure in the generation of primary generalized seizures. The few in vivo magnetic resonance (MR)-based studies in IGE patients suggest an altered cortical/subcortical gray matter ratio, but with no evidence of structural alterations of the thalamus. In this study, we sought to determine the volumes of the other subcortical structures.

[Current epilepsy treatment in adults].

The prevalence of epilepsy is about 1%. Only two thirds of these patients respond satisfactorily to an antiepileptic drug (AED) treatment. New AED did not clearly improve this overall efficacy, but often show a better tolerability as compared to old AED.

Ultrasound measurement of the fibrous cap in symptomatic and asymptomatic atheromatous carotid plaques.

Background: Fibrous cap thickness (FCT) is an important determinant of atheroma stability. We evaluated the feasibility and potential clinical implications of measuring the FCT of internal carotid artery plaques with a new ultrasound system based on boundary detection by dynamic programming.

Methods And Results: We assessed agreement between ultrasound-obtained FCT values and those measured histologically in 20 patients (symptomatic [S]=9, asymptomatic [AS]=11) who underwent carotid endarterectomy for stenosing (>70%) carotid atheromas.

Transitory sleep spindles impairment in deep cerebral venous thrombosis.

Sleep spindles may be affected by thalamic or hemispheric ischemic stroke. However, spindles reduction and their relationship with K-complexes following deep cerebral venous thrombosis have not been reported. An 18-year-old woman suffered from a deep cerebral venous thrombosis with vasogenic oedema located predominantly in the thalami.

Survey of management of first-ever seizures in a hospital based community.

Background: Epidemiological studies focusing on first-ever seizures have been carried out mainly on community based populations. However, since hospital populations may display varying clinical features, we prospectively analysed patients with first-ever seizure in a hospital based community to evaluate prognosis and the role of complementary investigations in the decision to administer antiepileptic drugs (AED).

Methods: Over one year, we recruited 177 consecutive adult patients with a first seizure acutely evaluated in our hospital.

Solid or gaseous circulating brain emboli: are they separable by transcranial ultrasound?

High-intensity transient signals (HITS) detected by transcranial Doppler (TCD) ultrasound may correspond to artifacts or to microembolic signals, the latter being either solid or gaseous emboli. The goal of this study was to assess what can be achieved with an automatic signal processing system for artifact/microembolic signals and solid/gas differentiation in different clinical situations. The authors studied 3,428 HITS in vivo in a multicenter study, i.

Propofol treatment of refractory status epilepticus: a study of 31 episodes.

Purpose: Refractory status epilepticus (RSE) is a critical medical condition with high mortality. Although propofol (PRO) is considered an alternative treatment to barbiturates for the management of RSE, only limited data are available. The aim of this study was to assess PRO effectiveness in patients with RSE.

Controlled contrast transcranial Doppler and arterial blood gas analysis to quantify shunt through patent foramen ovale.

Background And Purpose: A right-to-left shunt can be identified by contrast transcranial Doppler ultrasonography (c-TCD) at rest and/or after a Valsalva maneuver (VM) or by arterial blood gas (ABG) measurement. We assessed the influence of controlled strain pressures and durations during VM on the right-to-left passage of microbubbles, on which depends the shunt classification by c-TCD, and correlated it with the right-to-left shunt evaluation by ABG measurements in stroke patients with patent foramen ovale (PFO).

Methods: We evaluated 40 stroke patients with transesophageal echocardiography-documented PFO.

Automatic classification of HITS into artifacts or solid or gaseous emboli by a wavelet representation combined with dual-gate TCD.

Background And Purpose: Transcranial Doppler (TCD) can detect high-intensity transient signals (HITS) in the cerebral circulation. HITS may correspond to artifacts or solid or gaseous emboli. The aim of this study was to develop an offline automated Doppler system allowing the classification of HITS.

Uncommon ultrasound findings in traumatic extracranial vertebral artery dissection.

We report a case of internal carotid artery dissection (ICAD) associated with contralateral vertebral artery dissection (VAD). The interest of this case is to discuss an unusual Doppler pattern manifesting by a spectrum of an alternating vertebral artery flow suggesting a hemodynamic contribution from the contralateral vertebral artery (VA) and a clear depiction of both antegrade (red) and retrograde (blue) flow within the false and true lumen of the VAD by color Duplex flow imaging.

Midazolam premedication reduces propofol dose requirements for multiple anesthetic endpoints.

Purpose: This study investigates the interactions between midazolam premedication and propofol infusion induction of anesthesia for multiple anesthetic endpoints including: loss of verbal contact (LVC; hypnotic), dropping an infusion flex (DF; motor), loss of reaction to painful stimulation (LRP; antinociceptive) and attainment of electroencephalographic burst suppression (BUR; EEG).

Methods: In a double blind, controlled, randomized and prospective study, 24 ASA I-II patients received either midazolam 0.05 mg x kg(-1) (PM; n = 13) or saline placebo (PO; n = 11) i.