新生期大鼠反复痫性发作的形态学及行为学结果与糖皮质激素水平升高有关(英文)

目的探讨新生期大鼠反复痫性发作后的形态学,行为学以及糖皮质激素水平的变化。方法64只出生后一天的Wistar大鼠随机分为惊厥组40只和对照组24只。惊厥组的新生鼠在出生后1天(P1)、4天(P4)、7天(P7)给予腹腔注射匹罗卡品,制备新生鼠癫痫模型;对照组的新生鼠腹腔注射生理盐水。惊厥组分别在第 3次致痫后在即刻(Ⅰ组)、第4 天(Ⅱ组)、第14 天(Ⅲ组)、第42天(Ⅳ组)四个时间点处死,各时间点设相应对照组,处死前36 h惊厥组和对照组的大鼠腹腔注射BrdU。所有大鼠处死前均取血检测糖皮质激素。第Ⅳ组从P40开始进行Morris水迷宫试验。结果新生鼠3次发作后即刻和第4天与相应日龄对照组相比,齿状回BrdU阳性细胞数明显减少(P<0.05),而癫痫发作后14天和42天BrdU阳性细胞数增加,但发作后14天差异无统计学意义(P>0.05)。在4天的Morris水迷宫试验中,匹罗卡品处理组大鼠到达平台的时间均长于对照组,但是只有第1天和第2天有统计学意义(P<0.05)。检测结果表明高水平的糖皮质激素一直持续到发作后第4天,糖皮质激素水平与BrdU阳性细胞数呈负相关。结论新生大鼠反复痫性发作会造成早期神经发生减少,而后期神经发生增加;造成大鼠成年后认知功能缺陷;造成糖皮质激素水平增高,这与痫性大鼠形态学和行为学方面的改变有关。     

新生期大鼠反复痫性发作的形态学及行为学结果与糖皮质激素水平升高有关

目的探讨新生期大鼠反复痫性发作后的形态学,行为学以及糖皮质激素水平的变化。方法64只出生后一天的Wistar大鼠随机分为惊厥组40只和对照组24只。惊厥组的新生鼠在出生后1天（P1）、4天（P4）、7天（P7）给予腹腔注射匹罗卡品,制备新生鼠癫痫模型;对照组的新生鼠腹腔注射生理盐水。惊厥组分别在第3次致痫后在即刻（Ⅰ组）、第4天（Ⅱ组）、第14天（Ⅲ组）、第42天（Ⅳ组）四个时间点处死,各时间点设相应对照组,处死前36h惊厥组和对照组的大鼠腹腔注射BrdU。所有大鼠处死前均取血检测糖皮质激素。第Ⅳ组从P40开始进行Morris水迷宫试验。结果新生鼠3次发作后即刻和第4天与相应日龄对照组相比,齿状回BrdU阳性细胞数明显减少（P〈0．05）,而癫痫发作后14天和42天BrdU阳性细胞数增加,但发作后14天差异无统计学意义（P〉0．05）。在4天的Morris水迷宫试验中,匹罗卡品处理组大鼠到达平台的时间均长于对照组,但是只有第1天和第2天有统计学意义（P〈0．05）。检测结果表明高水平的糖皮质激素一直持续到发作后第4天,糖皮质激素水平与BrdU阳性细胞数呈负相关。结论新生大鼠反复痫性发作会造成早期神经发生减少,而后期神经发生增加;造成大鼠成年后认知功能缺陷;造成糖皮质激素水平增高,这与痫性大鼠形态学和行为学方面的改变有关。     

卡马西平对匹罗卡品诱导成年癫间疒大鼠海马齿状回神经前体细胞增殖的影响

目的研究卡马西平对成年癫大鼠海马齿状回内源性神经前体细胞增殖的影响。方法采用氯化锂和匹罗卡品联合诱导大鼠癫模型,将癫大鼠随机分为癫对照组和癫卡马西平组,正常大鼠随机分为正常对照组和正常卡马西平组。癫对照组和正常对照组给以蒸馏水灌胃,同时癫卡马西平组和正常卡马西平组给予卡马西平灌胃。于灌胃后第6d腹腔注射5-溴脱氧尿苷嘧啶(BrdU)标记海马齿状回的内源性神经前体细胞的增殖情况;用免疫组化方法观察各组大鼠在注射BrdU后第1d、第7d齿状回BrdU阳性细胞数量的表达。结果①注射BrdU后第1d,癫对照组大鼠海马齿状回BrdU阳性细胞数较正常对照组明显增加(P<0.01),癫卡马西平组大鼠海马齿状回BrdU阳性细胞数较癫对照组减少(P<0.05);②注射BrdU后第7d,癫对照组大鼠海马齿状回BrdU阳性细胞数较正常对照组明显增加(P<0.01),癫卡马西平组大鼠海马齿状回BrdU阳性细胞数较癫对照组明显减少(P<0.05)。结论卡马西平抑制癫大鼠海马齿状回内源性神经前体细胞增殖。     

匹罗卡品诱导癫痫大鼠内源性神经干细胞的可塑性改变

目的探讨匹罗卡品诱导癫痫模型的内源性神经干细胞的增殖、迁移,从而研究癫痫发生后的神经发生及可塑性改变.方法氯化锂和匹罗卡品联合诱导大鼠癫痫模型,分为对照组、癫痫发作后3、7、14、28 d组,用免疫组织化学方法动态检测大鼠海马多唾液酸神经细胞粘附分子(polysiolylated neural cell adhesion molecule,PSA-NCAM)及PSA-NCAM/5-溴脱氧尿苷嘧啶(bromodeoxyuridine,BrdU)的表达.结果与对照组比较,海马齿状回(dentate gyrus,DG)PSA-NCAM及PSA-NCAM/BrdU的阳性细胞在癫痫后3 d开始增加(P＜0.05),14 d达到高峰(P＜0.05),28 d后开始下降,但仍高于对照组(P＜0.05).结论癫痫发生后出现神经干细胞的增殖、迁移,也即出现了神经发生和可塑性改变.     

TLR9、MyD88在颞叶癫痫大鼠海马组织中表达的动态变化

目的观察氯化锂-匹罗卡品致痫大鼠各期海马中Toll-样受体9(TLR9)、髓样分化因子(MyD88)表达的变化,探讨其是否与颞叶癫痫发生有关。方法 SD雄性大鼠120只,随机分为对照组(30只)和模型组(90只),腹腔注射氯化锂。18 h~20 h后模型组腹腔注射匹罗卡品诱导癫痫持续状态(SE);对照组予等量生理盐水取代匹罗卡品腹腔注射。对照组和造模成功的模型组依据腹腔注射后时间随机分为10个亚组:急性模型组(SE后3 h、6 h、9 h、12 h、1 d、3 d、7 d);潜伏模型组(SE后14 d、28 d);慢自发发作组(SE后56 d)。每亚组动物模型组9只,对照组3只。免疫组化、蛋白印迹、RT-PCR技术测定各亚组癫痫大鼠海马内TLR9、MyD88的表达。结果TLR9、MyD88在模型组海马内表达明显增多,与对照组相比,差异有显著性(P0.05)。模型亚组内,TLR9、MyD88在急性期和慢性期表达明显增高,而潜伏期无明显表达变化。其中急性期内的增高多集中在癫痫发作后6 h;3组比较差异有显著性(P0.05)。结论大鼠海马内TLR9、MyD88表达增多可能与颞叶癫痫发病有关,探讨其机制可能为颞叶癫痫的治疗提供新的靶点。     

TLR4、MRP8在内侧颞叶癫痫幼大鼠海马中表达的动态变化

目的观察氯化锂-匹罗卡品致痫幼大鼠各期海马中Toll-样受体4(TLR4)、髓样相关蛋白8(MRP8)表达的变化,探讨其是否与内侧颞叶癫痫(MTLE)发生有关。方法 21d SD雄性大鼠90只,随机分对照组(30只)和模型组(60只),腹腔注射氯化锂。17～18h后模型组腹腔注射匹罗卡品诱导癫痫持续状态(SE);对照组予等量生理盐水取代匹罗卡品腹腔注射。按自发发作出现和稳定时间(自发痫性发作在致痫后约3w出现,8w趋稳定),对照组和模型组随机分6个亚组:急性模型组(SE后2h)、潜伏模型组(SE后3w)、慢性自发发作组(SE后8w)及相对应时间点对照组。每亚组动物10只。免疫组化、免疫印迹、RT-PCR技术测定各亚组幼大鼠海马内TLR4、MRP8的表达。结果 TLR4、MRP8在模型组海马内表达明显增多,以CA3、CA1、DG区显著;与对照组相比,差异有显著性(P0.05)。模型亚组内,TLR4、MRP8在急性期和慢性期表达明显增高,而潜伏期无明显表达变化;3组比较差异有显著性(P0.05)。结论大鼠海马内TLR4、MRP8表达增多可能与MTLE发生有关。探讨其机制可能为MTLE的治疗提供新的靶点。     

己酮可可碱预处理对癫痫发作大鼠海马损伤的影响

目的观察己酮可可碱(Ptx)预处理对癫痫发作大鼠海马损伤的影响。方法健康、成年雄性Wistar大鼠分为3组:对照组、癫痫组和Ptx预处理组。对照组腹腔注射生理盐水(127mg·kg~(-1));癫痫组和Ptx组大鼠用氯化锂-匹罗卡品(Li-Pc)诱发癫痫发作,先腹腔注射氯化锂(127mg·kg~(-1)),20h后背部皮下注射匹罗卡品(15mg·kg~(-1));Ptx组大鼠在匹罗卡品注射前30min通过腹腔给予Ptx(60mg·kg~(-1))。观察大鼠癫痫发作情况,利用Timm和Thionin染色分别观察海马苔藓纤维发芽(MSF)和神经元损伤情况。结果癫痫组大鼠在海马苔藓纤维发芽明显增多,并伴有海马神经元的损伤和脱失,Ptx预处理降低了Li-Pc诱发大鼠的癫痫发作率和癫痫发作程度,延长了其癫痫发作潜伏期,减轻了Li-Pc诱发大鼠海马的苔藓纤维出芽及神经元的损伤。结论 Ptx预处理缓解了Li-Pc诱发大鼠的癫痫发作和海马损伤,可能成为治疗癫痫的一种方法。     

Nectin-1在锂-匹罗卡品癫痫大鼠海马中的表达

目的为探讨Nectin-1在癫痫形成中的作用,我们采用经典的氯化锂-匹罗卡品大鼠癫痫模型,在点燃持续状态后不同时间点观察Nectin-1蛋白在大鼠脑海马的表达变化规律。方法①选用正常成年雄性SD大鼠,随机分为正常对照组(n=10)与模型组(n=50),模型组采用氯化锂-匹罗卡品腹腔注射法,对照组用等量生理盐水腹腔注射。成功点燃后存活的大鼠以(3 d、1周、2周、4周、6周)为研究时间点随机分为5个亚组,每组10只。②用Western-blot、免疫组化等经典方法观察Nectin-1蛋白在癫痫大鼠模型中的表达变化及规律。结果实验组大鼠腹腔注射匹罗卡品后,经过急性发作期及潜伏期、慢性期,出现癫痫反复的自发性发作,对照组未见急性及慢性发作。免疫组化染色对照组Nectin-1蛋白主要在胞膜及胞浆表达,在海马CA3区深染区域集中于透明层(SL)。癫痫组2周、4周时Nectin-1在齿状回有较多的阳性细胞,主要表现为胞浆和核膜棕色,并向内分子层分布。Western-blot与对照组相比,在匹罗卡品诱导的SE之后2周表达升高,一直持续到慢性期4周、6周。结论Nectin-1蛋白在癫痫大鼠模型SE后慢性期海马组织中表达较正常增高,可能与癫痫的形成机制有关。     

锂-匹罗卡品致癫大鼠早期大脑皮质MyT1 mRNA表达变化

目的 探讨氟化锂-匹罗卡品致癫大鼠脑髓鞘转录因子1基因表达变化及其意义。方法 以氯化锂、匹罗卡品对雄性成年SD大鼠先后腹腔注射，制成癫痫持续状态动物模型；采用5′末端标记地高辛的寡核苷酸探针荧光原位核酸分子杂交检测癫性发作后早期大鼠大脑皮质MyT1 mRNA阳性细胞数量。结果 与对照组相比，癫痫后1d组大鼠脑皮质MyT1 mRNA阳性细胞数减少（P＜0.05）；其他各组大鼠脑皮质MyT1 mRNA阳性细胞数都有明显的增加，其中癫痫后7d和14d组MyT1mRNA阳性细胞数都有非常显著的增加（P＜0.05，P＜0.01）。结论 氯化锂-匹罗卡品致癫大鼠早期大脑MyT1 mRNA表达增加，并有时程性变化，提示与早期脑损伤修复有关。     

托吡酯对锂-匹罗卡品诱导的慢性癫痫幼鼠反复发作的疗效观察

目的研究不同剂量托吡酯(TPM)长期应用对幼年慢性癫痫大鼠发作行为及体重的影响.方法出生后21天大鼠,使用锂-匹罗卡品制作癫痫持续状态(SE)后的慢性癫痫模型;不同剂量的TPM(20mg@kg-1@d-1,40 mg@kg-1@d-1,80 mg@kg-1@d-1)分2次灌胃给予,连续5周,在此期间每天观察大鼠行为学及体重变化,并比较对照组与各实验组结果的差异.结果大鼠在腹腔注射匹罗卡品后21～39 min(平均32 min)出现RacineⅣ级或Ⅴ级发作及癫痫持续状态(SE),SE后大鼠出现5～22 d(平均16.5 d)的静默期,其后大鼠进入慢性癫痫发作期,表现为Racine Ⅰ～Ⅲ级的自发反复发作(SRS).癫痫大鼠长期给予TPM时,其静默期长度无变化,慢性期单位时间内SRS明显减少.癫痫大鼠SE后的5周时体重较对照组减轻;癫癫大鼠TPM治疗组在TPM治疗5周时,其体重较未治疗组减轻.结论锂-匹罗卡品致大鼠SE后可出现慢性癫痫发作;长期应用TPM可抑制慢性癫痫大鼠的SRS,对于SE后的慢性癫痫具有明显抗癫痫作用;长期应用TPM可使癫痫大鼠的体重减轻.     

戊四氮致痫大鼠不同脑区神经肽Y的表达及意义

目的研究神经肽Y(neuropeptideY,NPY)在戊四氮(pentylenetetrazol,PTZ)致痫大鼠不同脑区中的变化,以探讨NPY与癫痫的关系。方法清洁级近交系雄性SD大鼠50只,分为对照组(A组,n=10)及实验组(40只)。实验组按体重50mg/kg经腹腔注射PTZ1次,对照组腹腔注射同等容量的生理盐水。根据癫痫发作分级,0~1级7只为B组,立即取脑;2级以上发作33只,随机于癫痫发作后0(C组,n=10)、6(D组,n=11)、24(E组,n=10)、72h(F组,n=2)取脑。采用放射免疫方法动态观察脑组织中海马、中脑、纹状体和额叶中NPY的改变;SP免疫组化染色法染色,观察各组大鼠海马CA1区NPY的表达。结果B组中脑、纹状体及额叶NPY含量较A组升高(P<005),而两组间海马NPY含量差异无显著性;癫痫发作组(C组、D组、E组)各部位NPY含量均明显高于A组。动态观察结果显示,癫痫发作后在中脑、海马、纹状体和额叶的NPY含量明显增高随后呈逐步下降,在癫痫发作后24h其含量与未发生惊厥的B组NPY含量差异无显著性(P>005);免疫组化染色显示癫痫大发作后海马NPY的表达明显增加,但随着时间的推移而降低。结论NPY与大鼠癫痫的发生、发展有密切关系。     

Cortical neurogenesis in adult rats after reversible photothrombotic stroke.

Neurogenesis occurs throughout life in the dentate gyrus of hippocampus and subventricular zone, but this phenomenon has rarely been observed in other brain regions of adult mammals. The aim of the current study was to investigate the cell proliferation process in the ischemically challenged region-at-risk after focal cerebral ischemia in the adult rat brain. A reversible photothrombotic ring stroke model was used, which features sustained hypoperfusion followed by late spontaneous reperfusion and a remarkable morphologic tissue recovery in the anatomically well defined somatosensory cortical region-at-risk. Twelve-week-old male Wistar rats received repeated intraperitoneal injections of the cell proliferation specific marker 5-bromodeoxyuridine (BrdU) after stroke induction. Immunocytochemistry of coronal brain sections revealed that the majority of BrdU-positive cells were of glial, macrophage, and endothelial origin, whereas 3% to 6% of the BrdU-positive cells were double-labeled by BrdU and the neuronspecific marker Map-2 at 7 and 100 days after stroke onset in the region-at-risk. They were distributed randomly in cortical layers II-VI. Three-dimensional confocal analyses of BrdU and the neuronal-specific marker Neu N by double immunofluorescence confirmed their colocalization within the same cells at 72 hours and 30 days after stroke induction. This study suggests that, as a potential pathway for brain repair, new neurons can be generated in the cerebral cortex of adult rats after sublethal focal cerebral ischemia.     

Malnutrition in infancy as a susceptibility factor for temporal lobe epilepsy in adulthood induced by the pilocarpine experimental model

Malnutrition during the earliest stages of life may result in innumerable brain problems. Moreover, this condition could increase the chances of developing neurological diseases, such as epilepsy. We analyzed the effects of early-life malnutrition on susceptibility to epileptic seizures induced by the pilocarpine model of epilepsy. Wistar rat pups were kept on a starvation regimen from day 1 to day 21 after birth. At day 60, 16 animals (8 = well-nourished; 8 = malnourished) were exposed to the pilocarpine experimental model of epilepsy. Age-matched well-nourished (n = 8) and malnourished (n = 8) rats were used as controls. Animals were video-monitored over 9 weeks. The following behavioral parameters were evaluated: first seizure threshold (acute period of the pilocarpine model); status epilepticus (SE) latency; first spontaneous seizure latency (silent period), and spontaneous seizure frequency during the chronic phase. The cell and mossy fiber sprouting (MFS) density were evaluated in the hippocampal formation. Our results showed that the malnourished animals required a lower pilocarpine dose in order to develop SE (200 mg/kg), lower latency to reach SE, less time for the first spontaneous seizure and higher seizure frequency, when compared to well-nourished pilocarpine rats. Histopathological findings revealed a significant cell density reduction in the CA1 region and intense MFS among the malnourished animals. Our data indicate that early malnutrition greatly influences susceptibility to seizures and behavioral manifestations in adult life. These findings suggest that malnutrition in infancy reduces the threshold for epilepsy and promotes alterations in the brain that persist into adult life.     

Consequences of pilocarpine-induced recurrent seizures in neonatal rats

Accumulated evidence have shown that a series of morphological alternations occur in patients with epilepsy and in different epileptic animal models. Given most of animal model studies have been focused on adulthood stage, the effect of recurrent seizures to immature brain in neonatal period has not been well established. This study was designed to observe the certain morphological changes following recurrent seizures occurred in the neonatal rats. For seizure induction, neonatal Wistar rats were intraperitoneally injected with pilocarpine on postnatal day 1 (P1), P4 and P7. Rat pups were grouped and sacrificed at 1d, 7d, 14d and 42d after the last pilocarpine injection respectively. Bromodeoxyuridine (BrdU) was intraperitoneally administered 36h before the rats were sacrificed. BrdU single and double labeling with neuronal markers were used to analyze cell proliferation and differentiation. Nissl and Timm staining were performed to evaluate cell loss and mossy fiber sprouting. Rats with neonatal seizures had a significant reduction in the number of Bromodeoxyuridine-(BrdU) labeled cells in the dentate gyrus compared with the control groups when the animals were killed either 1 or 7 days after the third seizure (P<0.05) but there was no difference between two groups on P21. On the contrary, BrdU-labeled cells significantly increased in the experimental group compared with control group on P49 (P<0.05). The majority of the BrdU-labeled cells colocalized with neuronal marker-NF200 (Neurofilament-200). Nissl staining showed that there was no obvious neuronal loss after seizure induction over all different time points. Rats with the survival time of 42 days after neonatal seizures developed to increased mossy fiber sprouting in both the CA3 region and supragranular zone of the dentate gyrus compared with the control groups (P<0.05). Taken together, the present findings suggest that synaptic reorganization only occurs at the later time point following recurrent seizures in neonatal rats, and neonatal recurrent seizures can modulate neurogenesis oppositely over different time window with a down-regulation at early time and up-regulation afterwards.     

Postictal in situ MRS brain lactate in the rat kindling model

OBJECTIVE: To determine the temporal and spatial extent of the lactate (Lact) changes as correlated with seizure characteristics and EEG changes in the rat kindling model. BACKGROUND: Prior studies using MRS have detected cerebral Lact postictally in animal models of seizures and in patients with intractable focal epilepsy. METHODS: We performed MRS in sham control rats (n = 4) and in rats stimulated in the right hippocampus at two different stages of the kindling and at three time points after the seizures: <2 hours (n = 8 and 5, stage 0 and stage 5), 2 to 3 hours (n = 5 and 6), and >3 hours (n = 4 and 2). Lact/creatine (Cr) and N-acetylaspartate (NAA)/Cr ratios were measured in six contiguous voxels (three left, three right) covering the hippocampi, anterior and posterior regions, and compared with EEG and ictal behavior. Lact/Cr ratios were measured at a very low level in the sham control rats and in the >3-hour group. RESULTS: In the <2-hour group, Lact/Cr increase was higher in stage-5 rats as compared with stage-0 rats (p = 0.001, unpaired t-test) and sham control rats when all the voxels were considered. Lact/Cr ratios were higher in the stimulated area as compared with all other brain areas in stage-0 rats (p = 0.05, paired t-test) but not in the stage-5 rats. Similar results with more inter-animal variability were measured in the 2- to 3-hour group. NAA/Cr ratios increased significantly after stage-0 kindling in the stimulated hippocampus but not after stage-5 kindling. CONCLUSIONS: Postictal Lact increase as assayed by MRS correlates with EEG and behavioral seizures and suggests that it would be an additional noninvasive technique for seizure localization during the presurgical evaluation of patients with intractable focal epilepsy.     

Spontaneous recurrent seizure following status epilepticus enhances dentate gyrus neurogenesis

It is known that evoked seizures can increase neurogenesis in the dentate gyrus in adult rats. Whether spontaneous seizures occurring after status epilepticus (SE) also results in alterations in neurogenesis is not known. Here, we measured neurogenesis in rats with and without spontaneous seizures following SE. Lithium-pilocarpine was used to induce seizures in postnatal (P) day 20 rats. Spontaneous seizure frequency was assessed 2 months using video monitoring. Rats then received bromodeoxyuridine to label dividing DNA and were sacrificed 24 h later. Animals with spontaneous seizures (n = 9) had a modest increase in neurogenesis compared to animals with SE (n = 6) and no spontaneous seizures and control rats (n = 10). These findings demonstrate that the hippocampus is capable of generating new neurons weeks following SE and further that recurrent seizures enhance the production of new neurons. These alterations in neurogenesis may contribute to ongoing pathological changes week and months following SE.     

Long-term survival and cell death of newly generated neurons in the adult rat olfactory bulb

In the adult rat olfactory bulb, neurons are continually generated from progenitors that reside in the lateral ventricle wall. This study investigates long-term survival and cell death of newly generated cells within the adult olfactory bulb. After injecting rats at 2 months of age with 5-bromodeoxyuridine (BrdU), the newly generated cells were quantified over a period of 19 months. A peak of BrdU-positive cells was reached in the olfactory bulb 1 month after BrdU injection, when all new cells have finished migrating from the ventricle wall. Thereafter, a reduction of BrdU-positive cells to about 50% was observed and it was confirmed by dUTP-nick end-labelling (TUNEL) that progenitors and young neurons undergo programmed cell death. However, cells that survived the first 3 months after BrdU injection persisted for up to 19 months. The majority of the BrdU-positive cells that reach the olfactory bulb differentiate into granule cells, but a small fraction migrate further into the glomerular layer. These newborn cells differentiate more slowly into periglomerular interneurons, with a delay of more than 1 month when compared to the granule cells. The newly generated periglomerular neurons, among them a significant fraction of dopaminergic cells, showed a similar decline in number compared to the granule cell layer and long-term survival for the remaining new neurons of up to 19 months. Rather than replacing old neurons, this data suggests that adult olfactory bulb neurogenesis utilizes the overproduction and turnover of young neurons, which is reminiscent of the cellular dynamics observed during brain development.     

Seizure precipitants in children with intractable epilepsy

PURPOSE: To investigate the seizure precipitants in children with intractable epilepsy, and to determine any distinctive clinical features contributing to seizures in these patients. METHODS: A questionnaire and seizure diary prepared by the parents of the patients. Demographic and seizure data were reviewed. RESULTS: Of 120 patients with intractable epilepsy, 74 (62%) had one (n=43), two (n=23), or three seizure precipitants (n=8). The three most common precipitants were illness or fever (32%), sleep deprivation (13%), and menstruation (10%). Of these precipitants, inducing factors (endogenous origin) were more common than triggering factors (exogenous origin): 73% versus 27%, respectively. Three distinctive clinical features - neurological abnormalities (P=0.01), status epilepticus (P=0.017), and abnormal neuroimaging (P=0.007) - were significantly more common in patients with than in patients without precipitants. CONCLUSIONS: Prompt recognition and management of seizure precipitants has practical implications for treating patients with refractory epilepsy. Such patients can be counseled to avoid specific precipitants.     

Effect of neural transplants on seizure frequency and kindling in immature rats following kainic acid.

To study the hypothesis that neural transplantations can alter seizure susceptibility in a chronic animal model of epilepsy 260 immature rats (30- to 32-days-old) were administered a convulsant dosage of kainic acid (KA). Ten days later rats that had severe seizures following KA received either bilateral intracerebroventricular transplants of hippocampal (n = 27), neocortical (n = 29), cerebellar (n = 30), or locus ceruleus (n = 32) tissue, or underwent sham transplantation (n = 66). Spontaneous seizure frequency was assessed for 230 days following which the rats underwent entorhinal kindling. The percentage of rats developing spontaneous recurrent seizures was similar in the 4 transplant groups and the sham-operated controls. Rats receiving hippocampal and locus ceruleus transplants had fewer spontaneous seizures than the sham-operated controls or other transplant groups. However, there were no differences in afterdischarge thresholds or kindling rates in the 5 groups. This study demonstrates that the anticonvulsant effects of neural transplants, using this animal model are mild. Tissue type of the graft appears to be an important variable in the alteration of seizure frequency.