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Post-Traumatic Epilepsy

Pedro Andrade, Jari Nissinen, Asla Pitkanen
Sleep disturbances commonly occur after traumatic brain injury and may predispose patients to epileptic seizures. We hypothesized that unprovoked seizure occurrence after traumatic brain injury depends on the sleep-wake cycle, and that the electrographic characteristics of a given sleep stage provide biomarkers for post-traumatic epilepsy. We show in a rat lateral fluid-percussion model that 92% of spontaneous generalized seizures occur during the transition from stage III to rapid-eye-movement sleep. Moreover, a reduction in spindle duration and dominant frequency during the transition stage present as specific and sensitive non-invasive biomarkers for experimentally induced post-traumatic epilepsy with generalized electrographic seizures...
October 5, 2016: Journal of Neurotrauma
Michael Larkin, R Michael Meyer, Nicholas S Szuflita, Meryl A Severson, Zachary T Levine
BACKGROUND: Many post-traumatic epilepsy (PTE) patients become resistant to medications. Nervous stimulation as a treatment for drug-resistant epilepsy (DRE) is an active area of clinical investigation. OBJECTIVE: To summarize methods, reported seizure control outcome measures, and adverse events from blinded, randomized control trials (RCTs) for selected invasive brain stimulation (IBS) and non-invasive brain stimulation (NIBS) treatment options in patients with DRE...
2016: Curēus
Zouhayr Souirti, Ahmed Sghir, Rachid Belfkih, Ouafae Messouak
INTRODUCTION: The aim of this study is to determine the clinical, paraclinical, therapeutic and outcome aspects of drug resistant patients with epilepsy in our region and consequently to discuss methods that may improve the management of these patients. PATIENTS AND METHODS: This paper presents a retrospective study of 25 adult patients that were followed for focal drug resistant epilepsy in epileptology unit of the University Hospital of Fez, Morocco. RESULTS: This study recorded 25 patients including 48% of males and 52% of females...
August 23, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Yu Song, Corrin Pimentel, Katherine Walters, Lauren Boller, Shabnam Ghiasvand, Jing Liu, Kevin J Staley, Yevgeny Berdichevsky
Exogenous Insulin-Like Growth Factor-1 (IGF-1) is neuroprotective in animal models of brain injury, and has been considered as a potential therapeutic. Akt-mTOR and MAPK are downstream targets of IGF-1 signaling that are activated after brain injury. However, both brain injury and mTOR are linked to epilepsy, raising the possibility that IGF-1 may be epileptogenic. Here, we considered the role of IGF-1 in development of epilepsy after brain injury, using the organotypic hippocampal culture model of post-traumatic epileptogenesis...
2016: Scientific Reports
Anssi Lipponen, Jussi Paananen, Noora Puhakka, Asla Pitkänen
We aimed to define the chronically altered gene expression signature of traumatic brain injury (TBI-sig) to discover novel treatments to reverse pathologic gene expression or reinforce the expression of recovery-related genes. Genome-wide RNA-sequencing was performed at 3 months post-TBI induced by lateral fluid-percussion injury in rats. We found 4964 regulated genes in the perilesional cortex and 1966 in the thalamus (FDR < 0.05). TBI-sig was used for a LINCS analysis which identified 11 compounds that showed a strong connectivity with the TBI-sig in neuronal cell lines...
2016: Scientific Reports
Xin You Tai, Matthias Koepp, John S Duncan, Nick Fox, Pamela Thompson, Sallie Baxendale, Joan Y W Liu, Cheryl Reeves, Zuzanna Michalak, Maria Thom
SEE BERNASCONI DOI101093/AWW202 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Temporal lobe epilepsy, the most prevalent form of chronic focal epilepsy, is associated with a high prevalence of cognitive impairment but the responsible underlying pathological mechanisms are unknown. Tau, the microtubule-associated protein, is a hallmark of several neurodegenerative diseases including Alzheimer's disease and chronic traumatic encephalopathy. We hypothesized that hyperphosphorylated tau pathology is associated with cognitive decline in temporal lobe epilepsy and explored this through clinico-pathological study...
September 2016: Brain: a Journal of Neurology
Jo Lebeer
BACKGROUND: The theory of Structural Cognitive Modifiability and Mediated Learning Experience of Reuven Feuerstein states that individuals with brain impairment, because of congenital or acquired origin, may substantially and structurally improve their cognitive functioning, by a systematic intervention based on a specific, criteria-based type of interaction ("mediated learning"). Three application systems are based on it: a dynamic-interactive assessment of learning capacity and processes of learning, the LPAD (Learning Propensity Assessment Device); a cognitive intervention program called "Instrumental Enrichment Program", which trains cognitive, metacognitive and executive functions; and a program, which is oriented at working in context, Shaping Modifying Environments...
June 18, 2016: NeuroRehabilitation
Tomoko Tanaka, N Scott Litofsky
INTRODUCTION: Pediatric post-traumatic epilepsy incidence varies depending on reporting mechanism and injury severity; anti-epileptic drug (AEDs) use also varies with lack of quality evidence-based data. Adverse AED effects are not negligible; some may negatively affect functional outcome. This review focuses on clarifying available data. AREAS COVERED: This review discusses seizures associated with traumatic brain injury in children, including seizure incidence, relationship to severity of injury, potential detrimental effects of seizures, potential benefits of AED, adverse effects of AED, new developments in preventing epileptogenesis, and suggested recommendations for patient management...
October 2016: Expert Review of Neurotherapeutics
Shi-Jie Liu, Ping Zheng, David K Wright, Gabi Dezsi, Emma Braine, Thanh Nguyen, Niall M Corcoran, Leigh A Johnston, Christopher M Hovens, Jamie N Mayo, Matthew Hudson, Sandy R Shultz, Nigel C Jones, Terence J O'Brien
There are no treatments in clinical practice known to mitigate the neurobiological processes that convert a healthy brain into an epileptic one, a phenomenon known as epileptogenesis. Downregulation of protein phosphatase 2A, a protein that causes the hyperphosphorylation of tau, is implicated in neurodegenerative diseases commonly associated with epilepsy, such as Alzheimer's disease and traumatic brain injury. Here we used the protein phosphatase 2A activator sodium selenate to investigate the role of protein phosphatase 2A in three different rat models of epileptogenesis: amygdala kindling, post-kainic acid status epilepticus, and post-traumatic epilepsy...
July 2016: Brain: a Journal of Neurology
Gordon G Cable
BACKGROUND: The occurrence of any intracranial bleeding is highly significant from an aeromedical risk perspective and potentially career-ending for a military aviator. Where it arises from head trauma, there is always concern regarding ongoing risk of post-traumatic epilepsy. CASE REPORT: A 26-yr-old male military aviator with persistent headache was found to have small right frontal and parietal subacute subdural hematomas, most likely precipitated by minor head trauma and possibly exacerbated by other concurrent physiological stressors...
June 2016: Aerospace Medicine and Human Performance
Andrey Khalafian, Charles Dukes, Phebe Tucker
Mr. R, a 27 year old Hispanic male with history of traumatic brain injury (TBI) over ten years prior but no psychiatric history, presents to the psychiatric consultation service with recent onset of mutism, psychotic behavior and new diagnosis of epilepsy. The differential diagnosis is broad and includes both medical and psychiatric causes: post-ictal state, non-convulsive status epilepticus, delirium due to metabolic conditions, drugs, catatonia, conversion disorder, major depression with psychotic features, new onset schizophrenia or a combination of these possible diagnoses...
August 2015: Journal of the Oklahoma State Medical Association
Konrad J Dębski, Asla Pitkanen, Noora Puhakka, Anna M Bot, Ishant Khurana, K N Harikrishnan, Mark Ziemann, Antony Kaspi, Assam El-Osta, Katarzyna Lukasiuk, Katja Kobow
This study tested the hypothesis that acquired epileptogenesis is accompanied by DNA methylation changes independent of etiology. We investigated DNA methylation and gene expression in the hippocampal CA3/dentate gyrus fields at 3 months following epileptogenic injury in three experimental models of epilepsy: focal amygdala stimulation, systemic pilocarpine injection, or lateral fluid-percussion induced traumatic brain injury (TBI) in rats. In the models studies, DNA methylation and gene expression profiles distinguished controls from injured animals...
2016: Scientific Reports
Anne C Ritter, Candace M Kammerer, Maria M Brooks, Yvette P Conley, Amy K Wagner
OBJECTIVE: Posttraumatic seizures (PTS) commonly occur following severe traumatic brain injury (sTBI). Risk factors for PTS have been identified, but variability in who develops PTS remains. Excitotoxicity may influence epileptogenesis following sTBI. Glutamate transporters manage glutamate levels and excitatory neurotransmission, and they have been associated with both epilepsy and TBI. Therefore, we aimed to determine if genetic variation in neuronal glutamate transporter genes is associated with accelerated epileptogenesis and increased PTS risk after sTBI...
June 2016: Epilepsia
Aleksandr Pevzner, Ali Izadi, Darrin J Lee, Kiarash Shahlaie, Gene G Gurkoff
Traumatic brain injury (TBI) can result in persistent cognitive, behavioral and emotional deficits. However, the vast majority of patients are not chronically hospitalized; rather they have to manage their disabilities once they are discharged to home. Promoting recovery to pre-injury level is important from a patient care as well as a societal perspective. Electrical neuromodulation is one approach that has shown promise in alleviating symptoms associated with neurological disorders such as in Parkinson's disease (PD) and epilepsy...
2016: Frontiers in Systems Neuroscience
Thomas Ostergard, Jennifer Sweet, Dorian Kusyk, Eric Herring, Jonathan Miller
Post-traumatic epilepsy (PTE) is defined as the development of unprovoked seizures in a delayed fashion after traumatic brain injury (TBI). PTE lies at the intersection of two distinct fields of study, epilepsy and neurotrauma. TBI is associated with a myriad of both focal and diffuse anatomic injuries, and an ideal animal model of epilepsy after TBI must mimic the characteristics of human PTE. The three most commonly used models of TBI are lateral fluid percussion, controlled cortical injury, and weight drop...
April 1, 2016: Journal of Neuroscience Methods
Carl H Gunderson, Robert B Daroff
Between December 1965 and December 1971, the United States maintained armed forces in Vietnam never less than 180,000 men and women in support of the war. At one time, this commitment exceeded half a million soldiers, sailors, and airmen from both the United States and its allies. Such forces required an extensive medical presence, including 19 neurologists. All but two of the neurologists had been drafted for a 2-year tour of duty after deferment for residency training. They were assigned to Vietnam for one of those 2 years in two Army Medical Units and one Air Force facility providing neurological care for American and allied forces, as well as many civilians...
2016: Frontiers of Neurology and Neuroscience
Corwin R Butler, Jeffery A Boychuk, Bret N Smith
The cascade of events leading to post-traumatic epilepsy (PTE) after traumatic brain injury (TBI) remains unclear. Altered inhibition in the hippocampal formation and dentate gyrus is a hallmark of several neurological disorders, including TBI and PTE. Inhibitory synaptic signaling in the hippocampus is predominately driven by γ-aminobutyric acid (GABA) neurotransmission, and is prominently mediated by postsynaptic type A GABA receptors (GABAAR's). Subsets of these receptors involved in tonic inhibition of neuronal membranes serve a fundamental role in maintenance of inhibitory state, and GABAAR-mediated tonic inhibition is altered functionally in animal models of both TBI and epilepsy...
June 2016: Experimental Neurology
Anatol Bragin, Lin Li, Joyel Almajano, Catalina Alvarado-Rojas, Aylin Y Reid, Richard J Staba, Jerome Engel
OBJECTIVE: To investigate possible electroencephalography (EEG) correlates of epileptogenesis after traumatic brain injury (TBI) using the fluid percussion model. METHODS: Experiments were conducted on adult 2- to 4-month-old male Sprague-Dawley rats. Two groups of animals were studied: (1) the TBI group with depth and screw electrodes implanted immediately after the fluid percussion injury (FPI) procedure, and (2) a naive age-matched control group with the same electrode implantation montage...
May 2016: Epilepsia
D Koji Takahashi, Feng Gu, Isabel Parada, Shri Vyas, David A Prince
Lesioned neuronal circuits form new functional connections after a traumatic brain injury (TBI). In humans and animal models, aberrant excitatory connections that form after TBI may contribute to the pathogenesis of post-traumatic epilepsy. Partial neocortical isolation ("undercut" or "UC") leads to altered neuronal circuitry and network hyperexcitability recorded in vivo and in brain slices from chronically lesioned neocortex. Recent data suggest a critical period for maladaptive excitatory circuit formation within the first 3days post UC injury (Graber and Prince 1999, 2004; Li et al...
July 2016: Neurobiology of Disease
Sandra Strazzer, Marco Pozzi, Paolo Avantaggiato, Nicoletta Zanotta, Roberta Epifanio, Elena Beretta, Francesca Formica, Federica Locatelli, Sara Galbiati, Emilio Clementi, Claudio Zucca
BACKGROUND: After traumatic brain injury, epilepsy affects up to 20 % of children. It is a risk factor, for both clinical recovery and cognitive performance; therefore pharmacological therapy is advisable. Current guidelines recommend prophylaxis to be initiated as soon as possible and tapered 1 week after trauma. However, no guideline exists for paediatric patients and the clinical practice is heterogeneous. OBJECTIVE: In our institute, prophylaxis was routinely tapered 6 months after trauma...
June 2016: Paediatric Drugs
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