Enhanced Interplay of Neuronal Coherence and Coupling in the Dying Human Brain.

The neurophysiological footprint of brain activity after cardiac arrest and during near-death experience (NDE) is not well understood. Although a hypoactive state of brain activity has been assumed, experimental animal studies have shown increased activity after cardiac arrest, particularly in the gamma-band, resulting from hypercapnia prior to and cessation of cerebral blood flow after cardiac arrest. No study has yet investigated this matter in humans.

Cerebrospinal Fluid Pleocytosis Not Attributable to Status Epilepticus in First 24 Hours.

Background: Status epilepticus (SE) has traditionally been thought to cause cerebrospinal fluid (CSF) pleocytosis. However, attributing CSF pleocytosis solely to SE without addressing the underlying etiology may lead to poor outcomes. Leukocyte recruitment to CSF has been shown to peak around 24 hours after prolonged seizures in animal studies, suggesting that CSF pleocytosis within the first 24 hours of SE onset may be due to underlying causes.

Plasma PrPC and ADAM-10 as novel biomarkers for traumatic brain injury and concussion: a pilot study.

Background: Cellular prion protein (PrPC) is a lipid raft protein abundant within CNS. It is regulated by a disintegrin and metalloproteinase domain containing protein 10 (ADAM10). PrPC has previously been implicated as a biomarker for TBI.

The Concept of an Epilepsy Brain Bank.

Epilepsy comprises more than 40 clinical syndromes affecting millions of patients and families worldwide. To decode the molecular and pathological framework of epilepsy researchers, need reliable human epilepsy and control brain samples. Brain bank organizations collecting and supplying well-documented clinically and pathophysiologically tissue specimens are important for high-quality neurophysiology and neuropharmacology studies for epilepsy and other neurological diseases.

Perampanel but Not Amantadine Prevents Behavioral Alterations and Epileptogenesis in Pilocarpine Rat Model of Status Epilepticus.

Pilocarpine-induced status epilepticus (SE), which results in the development of spontaneous recurrent seizures (SRSs) activates glutamatergic receptors that contribute to seizure sustenance and neuronal cell death. In the current study, we evaluate whether the exposure to perampanel, an α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor blocker, or amantadine, a N-methyl-D-aspartic acid (NMDA) receptor blocker would reduce the SE-induced long-term consequences. SE was induced in adult male Sprague Dawley rats with pilocarpine.

Update on Minimal Standards for Electroencephalography in Canada: A Review by the Canadian Society of Clinical Neurophysiologists.

Surface electroencephalogram (EEG) recording remains the gold standard for noninvasive assessment of electrical brain activity. It is the most efficient way to diagnose and classify epilepsy syndromes as well as define the localization of the epileptogenic zone. The EEG is useful for management decisions and for establishing prognosis in some types of epilepsy.

Evaluating the single seizure clinic model: Findings from a Canadian Center.

Introduction: The effect of the single seizure clinic (SSC) model on patient diagnose, work-up, wait-times, and clinical care is poorly characterized and its efficacy unclear. The present study assesses patient characteristics and evaluates the impact of a single seizure clinic (SSC) model on wait-times and access to care.

Material And Methods: A prospective study of all patients (n=200) referred to our SSC for first seizure evaluation.

How many adults with temporal epilepsy have a mild course and do not require epilepsy surgery?

Temporal lobe epilepsy (TLE) is the most common type of drug-resistant epilepsy in adults and commonly requires surgical treatment. While an overwhelming preponderance of literature supports the notion that a large percentage of patients with TLE benefit from surgery, there is a paucity of outcome data on patients who demonstrate a sustained response to pharmacological treatment. In this study, we present an adult cohort of patients with TLE, with the purpose of identifying the proportion of patients with a mild course of the disease, as well as potential risk factors.

StatNet Electroencephalogram: A Fast and Reliable Option to Diagnose Nonconvulsive Status Epilepticus in Emergency Setting.

Background: The StatNet electrode set is a system that can be applied by a non-electroencephalogram (EEG) technologist after minimal training. The primary objectives of this study are to assess the quality and reliability of the StatNet recordings in comparison to the conventional EEG.

Methods: Over 10 months, 19 patients with suspected nonconvulsive status epilepticus were included from university hospital emergency settings.

Discontinuation of antiepileptic drugs after successful surgery: who and when?

Surgery is a highly effective treatment for some specific types of refractory epilepsy and once seizure freedom is achieved many patients and clinicians have to ponder whether to taper or discontinue antiepileptic drugs (AEDs). However, there is no standard practice or guidelines and practices vary widely. The few studies that have addressed this question are retrospective and lack randomised, controlled comparisons, making it difficult to draw any solid inferences.

Ambulatory EEG: a cost-effective alternative to inpatient video-EEG in adult patients.

Introduction: Ambulatory electroencephalography (AEEG) is a monitoring technique that allows the recording of continuous EEG activity when patients are at home, without the necessity of admission to the hospital for prolonged video-EEG monitoring.

Methods: This is a prospective cohort study performed in a Canadian academic centre in order to assess the yield and tolerability of AEEG in the adult population. Over a period of three years, 101 patients were included.

How to measure fatigue in epilepsy? The validation of three scales for clinical use.

Fatigue can be defined as extreme and persistent tiredness, weakness or exhaustion that could be mental, physical or both. The main objective of this study is to validate three instruments to measure fatigue (Fatigue Symptom Inventory--FSI, Fatigue Assessment Instrument--FAI, Fatigue Severity Scale--FSS) in patients with epilepsy (PWE). We used concurrent validity as a method of validation.

Reasons for reoperation after epilepsy surgery: a review based on a complex clinical case with three operations.

The results of surgical treatment of epileptic seizures have gradually improved in the past decade, approaching 60% to 90% seizure-free outcome in temporal lobe epilepsy and 45% to 66% in extratemporal lobe epilepsy. Unfortunately some patients continue with seizures after epilepsy surgery and the studies have shown that approximately the 3% to 15% of patients with a previous failed surgical procedure are reoperated. Selected patients may be candidates for further surgery, potentially leading to a significant decrease in the frequency and severity of seizures.

Surgical outcomes in lesional and non-lesional epilepsy: a systematic review and meta-analysis.

Purposes: To provide evidence-based quantitative summary estimates of seizure outcomes in patients with non-lesional and lesional epilepsy treated with surgery, and to assess the consistency of results among published studies.

Methods: An exhaustive literature search identified articles published since 1995, describing outcomes according to lesional status in patients of any age who underwent resective epilepsy surgery. Two reviewers independently assessed study eligibility and extracted the data.

Safety and yield of early cessation of AEDs in video-EEG telemetry and outcomes.

Background: Video-electroencephalography (VEEG) telemetry is the simultaneous recording of ictal and interictal EEG pattern and paroxysmal behavior to investigate the nature of paroxysmal events.

Methods: This is a prospective study performed to asses the safety and yield of early discontinuation of antiepileptic drugs (AEDs) in the telemetry unit. Over a 2.

Gelastic seizures associated with hypothalamic hamartomas. An update in the clinical presentation, diagnosis and treatment.

Gelastic seizures are epileptic events characterized by bouts of laughter. Laughter-like vocalization is usually combined with facial contraction in the form of a smile. Autonomic features such as flushing, tachycardia, and altered respiration are widely recognized.

Occipital seizures induced by hyperglycemia: a case report and review of literature.

An 83-year-old right-handed male presented with a 2-day history of episodic jerking and "spasms" in the left arm, each lasting approximately 1min, followed by weakness. He also described episodes of flashing colorful lights (green and blue) in his left visual field, not always accompanied by arm jerking, associated with intermittent confusion. His past medical history was significant for type-2 diabetes mellitus.

Exercise restores coronary vascular function independent of myogenic tone or hyperglycemic status in db/db mice.

Regulation of coronary function in diabetic hearts is an important component in preventing ischemic cardiac events but remains poorly studied. Exercise is recommended in the management of diabetes, but its effects on diabetic coronary function are relatively unknown. We investigated coronary artery myogenic tone and endothelial function, essential elements in maintaining vascular fluid dynamics in the myocardium.

Sulfaphenazole treatment restores endothelium-dependent vasodilation in diabetic mice.

Vascular dysfunction is linked with increased free radical generation and is a major contributor to the high mortality rates observed in diabetes. Several probable sources of free radical generation have been suggested in diabetes, including cytochrome P450 (CYP) monooxygenase-dependent pathways. CYP-mediated superoxide production reduces nitric oxide (NO) bioavailability.

Increased vascular contractility in isolated vessels from cigarette smoking rats is mediated by basal endothelin release.

The effect of chronic cigarette smoking on endothelin modulation of vascular contraction, and CYP enzyme levels was studied in 20 male Sprague-Dawley rats. The animals were divided equally into smoking and non-smoking groups. The smoking group was exposed to 6 research cigarettes per rat per day 5 days a week for 16 weeks.

Cardiac transplantation and resistance artery myogenic tone.

Transplantation is an effective treatment for end-stage heart disease; however, most grafts eventually fail by progressive cardiac failure. Primarily, failure is ischemic due to the occlusive nature of transplant vascular disease (TVD). Early after transplantation and preceding TVD, alterations in coronary physiology such as reduced vascular myogenic tone occur.