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1.
No influences of chronic cerebellar stimulation were found in 10 different controlled experiments in 5 different monkeys with chronic alumina-induced psychomotor seizures. The stimulation parameters used were comparable to those used in human epileptics, and continuous daily EEG and behavioral monitoring allowed all seizures to be measured for daily frequency and duration over the several weeks of the experiments. Nocturnal seizures were similarly quantified in 3 monkeys to verify that cerebellar stimulation did not affect them. Motor cortex potentials evoked by cerebellar pulses confirmed that the stimulations were activating the cerebellum throughout the experiments, and measures of electrode access resistance and impedance verified that the electrodes remained in contact with the cerebellum. In one monkey given phenobarbital medication, interictal morbid behavior appeared to be improved by chronic stimulation of either cerebellum or dorsolateral frontal cortex, thus indicating an arousal influence of brain stimulation not due to cerebellum per se.  相似文献   

2.
Menkes DL  Gruenthal M 《Epilepsia》2000,41(2):240-242
PURPOSE: To evaluate the effect of slow-frequency repetitive transcranial magnetic stimulation (SF-rTMS) on interictal epileptiform activity and seizure frequency in a patient with medically refractory partial seizures due to focal cortical dysplasia. METHODS: A 9-cm circular coil was positioned over the area of cortical dysplasia. One hundred stimuli given at 0.5 Hz at 5% below motor threshold were given biweekly for four consecutive weeks. The EEG was recorded for 30 min before and after the first 100 stimuli. The number of seizures during the month of stimulation was compared with that of the month before stimulation. RESULTS: Stimulation was associated with a 70% reduction in the frequency of seizures and a 77% reduction in the frequency of interictal spikes. No seizures occurred during stimulation. CONCLUSIONS: SF-rTMS was safe and well tolerated in this patient. The reduction in seizures and interictal spikes associated with SF-rTMS supports the concept of SF-rTMS-induced cortical inhibition.  相似文献   

3.
The processes of development of seizures of the El mouse, an inbred mutant strain susceptible to epilepsy, were investigated by long-term clinical observations and EEG recordings. The phenomena of extinction, reinforcement, and an aftereffect of the antecedent occurrence of seizures were observed. Seizures of El mice were elicited by repetition of natural sensory stimulation, which consisted of observation and tossing procedures. The seizure thresholds were lowered with a repetition of stimuli, and the incidence of seizures became higher, attaining 100%. Clinical manifestations started with abortive forms several weeks after the mice were initially exposed to stimulation, and concluded with typical general convulsions and wild running. Paroxysmal discharges appeared in the EEG as isolated spikes, first from restricted parietal areas; subsequently spike and wave complexes were extedded over wide areas of the brain. Even during the interictal period isolated spikes sometimes could be seen in the EEGs of the El mice most susceptible to seizures. After a long period without stimulation, the thresholds were raised, or extinction of seizures was observed in mice with fully developed seizures. Reinforcement stimulation was necessary for seizures of El mice to occur constantly. During recovery of the occurrence of seizures, their incidence increased sooner than in the previous developmental period. In general, the El mouse seizure might represent an abnormal plastic phenomenon associated with repetition of sensory stimuli in addition to genetic predisposition and ontogenetic development.  相似文献   

4.
Summary: Five patients with chronic incapacitating seizures averaging 15–5,000/month were selected for study. All patients had more than one seizure type and had received maximal doses of antiepileptic drugs (AEDs). The centromedian thalamic nucleus (CM) was stimulated electrically through bilateral multicontact platinum electrodes stereotaxically placed in CM and connected to internalized pulse generators. Electrophysiologic confirmation of electrode position included thalamically elicited recruiting responses and EEG desynchronization recorded at the scalp. Stimulation parameters were adjusted individually in the range of 450–800-μA intensity, 65 pps, 0.09 ms, in 1-min trains, alternating right and left side stimulation and with 4-min intervals delivered for 2 h/day. Quantitative evaluation included frequency of seizures/month, number of maximal interictal paroxysmal discharges, and frequency of background activities counted in selected scalp EEG samples, taken throughout the observation period (7–33 months). Significance of changes was evaluated by parametric Student's t test. Generalized tonic-clonic seizures (GTC) decreased dramatically, almost disappearing in all cases (p < 0.001), with a significant reduction in interictal paroxysmal discharges (p < 0.01) and a tendency toward an increase in EEG back-ground frequency. Other generalized seizures (atypical absences) decreased significantly, but there was no change in the number of complex partial seizures (CPS). CM stimulation is useful in control of GTC, but its beneficial effect on other seizure types has not been established.  相似文献   

5.
Bragin A  Azizyan A  Almajano J  Wilson CL  Engel J 《Epilepsia》2005,46(10):1592-1598
PURPOSE: The goal of this study was to analyze the transition period between interictal and ictal activity in freely moving rats with recurrent spontaneous seizures after unilateral intrahippocampal kainic acid (KA) injection. METHODS: Pairs of tungsten electrodes (50 microm O/D) were implanted bilaterally under anesthesia at symmetrical points in the dentate gyrus (DG) and CA1 regions of anterior and posterior hippocampi and entorhinal cortex of adult Wistar rats. Stimulating electrodes were placed in the right angular bundle and KA was injected into the right posterior CA3 area of hippocampus after 1 week of baseline EEG recording. Beginning 24 h after injection, electrographic activity was recorded with video monitoring for seizures every day for 8 h/day for 60 days. RESULTS: Seventy percent of seizures started locally in the DG ipsilateral to injection, with an increase in frequency of interictal EEG spikes (hypersynchronous type, HYP), and 26% of seizures started with a decrease of EEG amplitude with parallel increase in frequency (low-voltage fast type, LVF). During HYP seizures, a significant increase was observed in amplitude of beta-gamma range frequencies, ripple frequency, and fast ripple (FR) frequency, whereas during LVF seizure, an increase was noted only in the beta-gamma range. In all cases but one, an EEG wave preceded ripple and FR oscillations. Before seizure onset, the amplitude of DG-evoked responses to single pulses decreased, whereas the amplitude of the response to the second pulse delivered at 30-ms interval increased. CONCLUSIONS: If ripple and FR oscillations indicate the seizure-generating neuronal substrate, these areas must be small and widespread, so that the probability of recording from them directly is very low. The decreased response to electrical stimulation before seizures could indicate a protective inhibitory mechanism that contains or prevents seizure occurrence. The presence of decreased paired-pulse suppression could indicate a network predisposition to follow an external input with a certain frequency.  相似文献   

6.
视频脑电图监测对癫痫的诊断价值   总被引:12,自引:1,他引:11  
目的探讨视频脑电图(Video-EEG)对癫痫的诊断价值.方法对252例发作性疾病患者进行连续12~24小时监测,其中包括清醒、睡眠及诱发试验,分析临床发作和异常放电的关系,异常放电出现的时相,癫痫分型与异常放电的关系,临床发作前脑电图的改变以及临床发作间期和发作期异常脑电图的不同表现.结果252例监测到临床发作142例,其中同时伴异常放电者为111例;252例检出异常放电187例,其中出现于睡眠期者146例;确诊的111例中103例确定了发作类型,其中25例修正了发作类型;确诊的111例监测到发作前脑电图的异常改变,表现为背景脑电波频率和波幅的改变,或者出现痫样放电;111例不同发作类型癫痫患者发作间期和发作期有不同的异常脑电图表现.结论视频脑电图可提高痫样放电的检出率,有助于癫痫的诊断及分型,有利于观察癫痫患者发作间期及发作期脑电图的表现.  相似文献   

7.
The effects of electrical stimulation of the vagus nerve, a proposed treatment for patients with intractable epilepsy, on focal interictal spikes produced by penicillin and EEG secondarily generalized seizures induced by pentylenetetrazol were assessed in rats. Interictal spike frequency was reduced by 33% during 20 s of stimulation (p < 0.001) and remained low for ≤3 min. Amplitude of residual spikes was also decreased. Cardiac and respiratory rates were suppressed. Cooling the nerve proximal to the point of stimulation abolished the EEG and respiratory effects. A similar reduction in spike frequency of 39% was obtained by heating the animals' tail (p < 0.01). Vagal stimulation at onset of seizures reduced mean seizure duration from 30.2 ± 15.7 s without stimulation to 5.0 ± 1.8 s (p < 0.01). Only the EEG equivalent of the clonic phase of the seizure was affected. These findings suggest that vagus nerve stimulation can be a potent but nonspecific method to reduce cortical epileptiform activity, probably through an indirect effect mediated by the reticular activating system.  相似文献   

8.
OBJECTIVE: To evaluate the antiepileptic effect of low-frequency rTMS (repetitive transcranial magnetic stimulation) in the patients with intractable epilepsy. METHODS: We enrolled 35 patients with localization-related epilepsy who had experienced at least one complex partial seizure or a secondarily generalized seizure per week on a constant antiepileptic drug regimen over an 8-week period. rTMS was administered using a Rapid(2) magnetic stimulator with an air-cooled coil at 0.5Hz for 5 consecutive days at 100% of rMT (resting motor threshold). Patients were divided into a focal stimulation group with a localized epileptic focus, or a non-focal stimulation group with a non-localized or multifocal epileptic focus. These two groups were then randomly subdivided into four subgroups depending on the total number of stimulations administered, i.e., 3000 pulse and 1500 pulse subgroups. Weekly seizure frequencies were determined for 8 weeks before and after rTMS. To compare the number of interictal spikes before and after rTMS, EEG was recorded twice before (1st day) and after rTMS (5th day). RESULTS: Mean weekly seizure frequency was non-significantly decreased after rTMS (8.4-->6.8/week, -13.9%). Longer stimulation subgroups (3000 pulses, -23.0%) tended to have fewer seizures than shorter stimulation subgroups (1500 pulses, -3.0%), without statistical significance. TMS stimulation site and structural brain lesions did not influence seizure outcome. However, interictal spikes significantly decreased (-54.9%, P=0.012) after rTMS and they totally disappeared in 6 patients (17.1%, 6/35). CONCLUSIONS: Low-frequency rTMS reduced interictal spikes, but its effect on seizure outcome was not significant. Focal stimulation for a longer duration tended to further reduce seizure frequency. SIGNIFICANCE: These findings may help clinicians to further investigate the therapeutic potential of the rTMS for patients with intractable epilepsy.  相似文献   

9.
The multiunit activity in the medial septal–diagonal band complex (MSDB) and field potentials of the hippocampus were simultaneously recorded in waking healthy rabbits (control) and in the same animals that were then exposed to kindling stimulation of the perforant path. In the control, the bursts of spikes in one group of rhythmic MSDB neurons phase-locked to the top of theta waves in the hippocampus, and in the second group, to the trough of these waves. The stimulation evoked seizure afterdischarges in the hippocampus and seizure bursts of spikes separated by periods of inhibition in MSDB neurons. In the first group of septal cells, seizure bursts coincided with inhibitory periods between afterdischarges in the hippocampus; in the second group, these bursts were observed during seizure afterdischarges, suggesting that different MSDB cells play opposite roles in the development of seizures. Evoked afterdischarges were spontaneously followed by recurrent ictal events; neuronal oscillations at the theta (6–7 Hz) or “twice-theta” frequency (12–14 Hz) preceded these secondary epileptic discharges. As a result of kindling, interictal spikes were recorded in the hippocampus; at the same time, synchronous bursts of many cells appeared in the MSDB. In the epileptic brain, the frequency of both the hippocampal theta rhythm and MSDB neuronal theta bursts increased; in the septum, an augmentation of neuronal rhythmicity was also observed. Theta oscillations, either spontaneous or evoked by sensory stimulation, abolished the epileptiform events. Evidently, the activities within the theta range during preictal and interictal periods are of different significance in the generation of seizures.  相似文献   

10.
OBJECTIVES: We wanted to investigate factors that are associated with frequency of interictal epileptiform discharges by investigating 303 patients with temporal lobe epilepsy (TLE). METHODS: We included all patients who consecutively underwent the adult presurgical evaluation program at our center and who had intractable, medial TLE with complex partial seizures due to unilateral medial temporal lobe lesions. The interictal EEG samples were automatically recorded and stored on computer. The location and frequency of interictal epileptiform discharges were assessed by visual analysis of interictal EEG samples of 2-minute duration every hour. RESULTS: There were 303 patients (aged 16-63) who met the inclusion criteria. The median interictal epileptiform discharge frequency was 15 IED/h, the median seizure frequency was 4 seizures/month. According to univariate analyses, we found that age at monitoring, epilepsy duration, and higher seizure frequency were associated with higher interictal epileptiform discharge frequency. In the logistic regression analysis, we found that higher seizure frequency (p < 0.001) and longer epilepsy duration (p = 0.007) were independently associated with higher spike frequency, while the age at monitoring was not. CONCLUSIONS: Seizure frequency and epilepsy duration (years of patient's life with seizure activity) were independently associated with IED frequency, suggesting that IED are modulated by seizures.  相似文献   

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