Selection criteria for surgery--clinical features and EEG including invasive techniques.

Preconditions, selection criteria for surgical treatment of epilepsy and some aspects of the presurgical evaluation are discussed. Identification of those patients who will profit from epilepsy surgery, exact localization of the seizure generating structures, and evaluation of the potential risks of the proposed operation are the main goals of the preoperative diagnostic procedures. The localizational value of certain seizure patterns and ictal clinical signs and symptoms is reviewed and illustrated with symptoms provoked by electrical stimulation of the brain.

The Zürich amygdalo-hippocampectomy series: a short up-date.

Selective amygdalohippocampectomy was developed as a surgical treatment for temporal lobe epilesy with a well-defined unilateral mesiobasal limbic seizure onset. Since 1975, 236 patients have been operated on in Zürich. We briefly summarize recent studies on the seizure outcome with analysis of the postoperative long-term fluctuations in relation to postoperative anticonvulsant drug treatment, on the underlying neuropathology, and on the relationships between magnetic resonance scanning estimates of total volume of the removed tissue and the resection scores of amygdala, hippocampus and parahippocampus gyrus.

Immunocrossreactivity of antisera against grain prolamines of wheat, rye, barley and oats.

Prolamines extracted from wheat (gliadin), rye (secalin), barley (hordein) and oats (avenin) were used to raise antibodies in rabbits. The four prolamines were separated by SDS-PAGE and blotted onto nitrocellulose. The immunocrossreactivity of the separated prolamines with the four antisera was studied.

[Long-term EEG follow-up of 30 patients with large resections in severe extra-temporal epilepsy].

This study presents postoperative scalp EEG-findings of 30 patients operated on for drug resistant epilepsies of extratemporal origin. The primary epileptogenic area was preoperatively defined by means of stereo-electroencephalography (SEEG). The amount and the distribution of postoperatively recorded epileptiform abnormalities were compared to the seizure outcome, to the location and extent of the resection and to the preoperative SEEG results.

[Long-term electroencephalography follow-up of patients with selective amygdaloid-hippocampectomy].

The EEGs of 149 patients with drug-resistant psychomotor epilepsy were analysed before and after amygdalohippocampectomy. The extent of the pre- and postoperative EEG abnormalities was compared. In particular we were interested whether there is a difference in patients with a structural lesion compared to those with no structural lesion, and if so, in which EEG-parameters the difference lies (background activity, homo- and contralateral focal slowing, homo- and contralateral epileptogenic focus, generalized epileptiform abnormalities).

Comparative investigations of partial amino acid sequences of prolamins and glutelins from cereals. VIII. Amino acid sequences of glutelin peptides.

The peptide fractions isolated from chymotryptic hydrolysates of wheat, rye and barley glutelins were separated by high-performance liquid chromatography on octadecyl silica gel. The peptides obtained were analysed for their amino acid composition and some also for their amino acid sequence. Characteristic sequences of peptides from wheat glutelin can be grouped into three types.

Antennnal olfactory and behavioral response of southern pine beetle,Dendroctonus frontalis, to analogs of its aggregation pheromone frontalin.

Antennal olfactory (electroantennogram) and laboratory and field behavioral tests were carried out on the response ofDendroctonus frontalis to its aggregation pheromone frontalin and analogs. The analogs were compounds modified by altering the position and methyl groups and/or by their deletion. Any modification to the frontalin structure significantly reduced both the antennal olfactory and behavioral response byD.

Handling of gliadin peptides B1-B4 and of cow's milk proteins by rat jejunum gut sacs.

The rat everted gut sac was used as a model of intestinal protein and peptide handling to study small intestinal binding and uptake of different gliadin peptide fractions (B1, B2, B3, B4) in comparison with bovine serum albumin (BSA), alpha-lactalbumin (alpha-LA), and a BSA peptide fraction (BSA-P). Not only binding curves, but also uptake curves of BSA, alpha-LA, and BSA-P were run in parallel between 1 and 30 min. Binding and uptake obviously depended on molecular weight.

Food proteins and maturation of small intestinal microvillus membranes (MVM). II. Binding of gliadin hydrolysate fractions and of the gliadin peptide B3142.

To investigate in vitro interactions between gliadin peptide fractions that have been shown to be toxic to celiac small intestinal mucosa in humans and small intestinal microvillus membranes (MVM) from rats during postnatal maturation, MVM were prepared from newborn, 18-day-old preweanling, and adult rats. Partially hydrolyzed gliadin peptide fractions B1-B4, and the pure gliadin peptide B3142 were radioiodinated and used for binding assays. Miniature ultracentrifugation was used for separation of unbound material.

Selective amygdalo-hippocampectomy for temporal lobe epilepsy.

Greater precision in the identification of seizure-initiating structures and preferential pathways of seizure spread has enabled us to classify complex partial seizures into subtypes. The mediobasal limbic subtype is the most important of these. Because of the paramount importance of amygdala and hippocampus in the majority of patients with temporal lobe epilepsy, we initiated so-called "selective" amygdalo-hippocampectomy (AHE) as an alternative to conventional temporal lobectomy for the treatment of medically intractable mediobasal temporal lobe epilepsy.

High-performance liquid chromatography of reduced glutenin: amino acid composition of fractions and components.

Reduced glutenin is separated by gel permeation high-performance liquid chromatography into three major and five minor fractions, which significantly differ in their amino acid compositions. By reversed-phase high performance liquid chromatography, about 20 glutenin components are obtained. These can be classified into three groups according to their amino acid compositions: a hydrophilic group with relatively high values of Glx and Phe, a more hydrophobic group with a high content of Gly, and a strongly hydrophobic group with higher values of Val and Leu.

[Comparative study of partial amino acid sequences of prolamins and glutelins from various cereals. VII. Amino acid sequences of prolamin peptides].

The peptide fractions isolated from chymotryptic hydrolysates of wheat, rye and barley prolamines [this journal (1984) 178:173] were separated into pure peptides by high-performance liquid chromatography on octadecyl silica gel. The peptides which were most abundant were analyzed for amino acid composition and in part for amino acid sequence. Besides peptides which are typical for only one of the cereals investigated, peptides of similar composition were found in all three prolamines.

Effects of gliadin peptides B1-B4 in celiac disease. I. Organ culture studies.

Small intestinal organ culture was used as an in vitro system to study the enterotoxic effects of gliadin peptides. Measurement of enterocyte height proved to be a reliable and reproducible way of assessing mucosal change during organ culture. Enterocyte height decreases nonspecifically in normal cultured mucosa, whereas the height of enterocytes of celiac mucosa increases in vitro in controls.

Coeliac activity of the gliadin peptides CT-1 and CT-2.

The coeliac active peptide B 3142, which has been isolated from a peptic-tryptic digest of gliadin and which consists of 53 amino-acid sequences, was partially hydrolyzed with alpha-chymotrypsin. The two fragment peptides CT-1 (positions 1-22 of B 3142) and CT-2 (positions 23-53) were separated by high-performance liquid chromatography on octadecyl silica gel and purified by gel filtration on Biogel P2. The examination in the organ-culture test including 18 coeliac patients on normal diet and 7 control persons have shown that the toxicity is preserved after the chymotryptic treatment and that the peptides B 3142, CT-1 and CT-2 do not significantly differ from one another according to their coeliac-specific effect.

Musical consonances and dissonances: are they distinguished independently by the right and left hippocampi?

Our study sought to determine whether, where and how the consonance or dissonance of musical intervals might be reflected in the electrical activity (depth EEG) of the human brain. Presenting an adequate musical test program to a patient with depth electrodes implanted within the planum temporale (near Heschl's gyrus) and the hippocampal formations of both sides, we found that the reactions shown by the depth EEG of the limbic system correspond in precise and distinctly differing patterns to the consonances and dissonances presented. The main findings are: the EEG of the left hippocampus reflects the consonance-dissonance dichotomy; the activity of the left hippocampus but not the right is affected by a previous sequence of dissonances in responding to a single consonance; the EEG activity of the right Heschl's gyrus (the left Heschl's gyrus was not analyzed), but neither the left nor the right hippocampus, responded differently to a given succession of intervals and its pitch inversion.

Glutamic acid decarboxylase immunoreactivity in sector CA1 of the human Ammon's horn.

The distribution of glutamic acid decarboxylase (GAD) immunoreactive neurons, fibres and punctae in sector CA 1 of the adult human Ammon's horn was studied in Vibratome sections (40 micron thick) of tissue obtained at surgery and autopsy. On light microscopical examination, the material did not show pathological changes. The antibody was visualized by the unlabelled antibody enzyme method.

The 'foramen ovale electrode': a new recording method for the preoperative evaluation of patients suffering from mesio-basal temporal lobe epilepsy.

A technique to record from the mesio-basal aspect of the temporal lobe by a subdural electrode inserted through the foramen ovale (FO) is described. For this purpose a special electrode was developed that, in addition, allowed epicortical DC recording. After having tested its value experimentally in dogs with penicillin-induced hippocampal seizure foci, this 'FO electrode' was subsequently applied to 10 patients.

[Current possibilities of the operative treatment of epilepsy].

Interest in surgical treatment for epileptic seizures has increased considerably over the last decades. Better understanding of the epileptic process itself and the advent of new functional diagnostic means have led to the recognition that 11%-50% of patients with partial seizures might benefit from surgery. The major aspects of this review article include a discussion of the criteria that must be met before considering surgery and the need to establish a proper diagnosis.

Functional inhibition and release: unilateral tachistoscopic performance and stereoelectroencephalographic activity in a case with left limbic status epilepticus.

During prolonged nonconvulsive unilateral left limbic status epilepticus, a natural model of functional hemispheric inhibition, we performed two tachistoscopic experiments, a lexical decision task associated with a RVF (left hemisphere) superiority and a facial matching task associated with a LVF (right hemisphere) superiority. We found that epileptic activity in the left hemisphere, especially rhythmic high-frequency "tonic" discharges, inhibited performance on the lexical task but not on the facial matching task. This suggests that only cognitive activity in the discharging hemisphere is inhibited.

Unilateral limbic epileptic status activity: stereo EEG, behavioral, and cognitive data.

We report data from four patients with unilateral epileptiform status activity within different structures of the temporal lobe, recorded during stereoelectroencephalographic presurgical evaluation. The ictal clinical symptoms accompanying neocortical and mesiobasal limbic discharges (two patients with complex partial status epilepticus) consisted of various psychosensory and vegetative signs, which can be understood on the basis of the spatiotemporal analysis of the discharges. The other two patients with circumscribed long-lasting mesiobasal limbic epileptiform activity represent unilateral pure limbic status epilepticus and were characterized by a marked behavioral syndrome (with stickiness, aggressivity, etc.