Navegando por Palavras-chave "System epilepsies"

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    Olfactory stimulation induces delayed responses in epilepsy
    (Academic Press Inc Elsevier Science, 2016) Lunardi, Mariana S.; Lin, Katia; Mameniskiene, Ruta; Beniczky, Sandor; Bogacz, Alicia; Braga, Patricia; Guaranha, Mirian S. B. [UNIFESP]; Yacubian, Elza M. T. [UNIFESP]; Samaitiene, Ruta; Baykan, Betul; Hummel, Thomas; Wolf, Peter
    Precipitation and inhibition of seizures and epileptic discharges by sensory stimuli are receiving increasing attention because they provide insight into natural seizure generation in human epilepsies and can identify potential nonpharmacological therapies. We aimed to investigate modulation (provocation or inhibition) of epileptiform discharges (EDs) in mesial temporal lobe epilepsy (MTLE) versus idiopathic generalized epilepsy (IGE) by olfactory stimulation (OS) compared with standard provocation methods. The underlying hypothesis was that any response would be more likely to occur in MTLE, considering the anatomical connections of the temporal lobe to the olfactory system. This multicenter, international study recruited patients with either MTLE or IGE who were systematically compared for responses to OS using an EEG/video-EEG protocol including a 30-min baseline, twice 3-min olfactory stimulation with ylang-ylang, hyperventilation, and intermittent photic stimulation. The 95% confidence interval (CI) for the baseline EDs in each patient was calculated, and modulation was assumed when the number of EDs during any 3-min test period was outside this CI. A total of 134 subjects (55 with MTLE, 53 with IGE, and 26 healthy controls) were included. Epileptiform discharges were inhibited during OS in about half the patients with both MILE and IGE, whereas following OS, provocation was seen in 29.1% of patients with MILE and inhibition in 28.3% of patients with IGE. Olfactory stimulation was less provocative than standard activation methods. The frequent subclinical modulation of epileptic activity in both MTLE and IGE is in striking contrast with the rarity of reports of olfactory seizure precipitation and arrest. Inhibition during OS can be explained by nonspecific arousal. The delayed responses seem to be related to processing of olfactory stimuli in the temporal lobe, thalamus, and frontal cortex. (C) 2016 Elsevier Inc. All rights reserved.
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    Praxis induction. Definition, relation to epilepsy syndromes, nosological and prognostic significance. A focused review
    (W B Saunders Co Ltd, 2014-04-01) Yacubian, Elza Márcia Targas [UNIFESP]; Wolf, Peter; Universidade Federal de São Paulo (UNIFESP); Danish Epilepsy Ctr
    Purpose: There is increasing awareness that reflex epileptic mechanisms provide unique insight into ictogenesis in human epilepsies. Several of the described triggers have in common that they imply complex visuomotor coordination and decision-making; they are today regarded as variations of one principle, i.e. praxis induction (PI). This focused review considers PI from the aspects of history and delineation, clinical and electroencephalographic presentation, syndromatic relations, prevalence, mechanisms of ictogenesis and nosological implications, treatment and prognosis.Methods: We reviewed a series of published articles and case reports on PI in order to clarify clinical and electroencephalographic findings, treatment and outcome.Results: Findings of both induction and inhibition by the same stimuli suggest widening the reflex epilepsy concept into a broader one of epilepsies with exogenous modification of ictogenesis. PI is closely related to juvenile myoclonic epilepsy (JME) where hyperexcitability and hyperconnectivity of the entire network of visuomotor coordination seem to provide the precondition for eliciting reflex myocloni in the musculature active in the precipitating task.Conclusion: the conclusions on ictogenesis derived from PI support the concept of JME as a system disorder of the brain. (C) 2014 British Epilepsy Association. Published by Elsevier B.V. All rights reserved.