Psychopathology and personality characteristics of epileptic patients: epilepsy, psychopathology and personality

The psychiatric investigation of a sample of 101 epileptic patients (65 temporal lobe epileptics (TLE) and 36 non-TLE) through various methods of evaluation, showed that only a minority of TLE with DSM-III diagnoses of Organic Brain Syndromes had severe psychopathology and manifested some personality traits. Thus, these patients seem to be differentiated from the rest of epileptics, TLE and non-TLE, who had quite "benign" psychological problems, if at all. It is quite probable that this sub-group of TLE could be the main instigators and perpetrators of the "bad image" of epileptics. The findings are discussed in relation to the pertinent literature and some hypotheses are offered for their explanation.     

Hot-Water Epilepsy: A Variant of Reflex Epilepsy in Southern India

"Hot water epilepsy" (HWE), precipitated by a bath or shower in hot water, has been described infrequently in the literature. We report 279 cases of HWE that were seen between 1980 to 1983 in Bangalore, South India. We found HWE to be more common in children, with cases more frequent among male than female patients (2.6:1). Complex partial seizures constituted the main clinical presentation (67.0%); HWE accounted for 4.4% of all complex partial seizures and generalize tonic-clonic seizures seen at our center during the 1980-1983 period. Although prognosis seems favorable 25.4% of our patients developed nonreflex epilepsy within 1-3 years. They were managed with antiepileptic drugs and the use of lukewarm water for bathing.     

Presynaptic regulation of the electrically evoked release of endogenous dopamine from the isolated neurointermediate lobe or isolated neural lobe of the rat pituitary gland in vitro

Summary Isolated neurointermediate lobes (NILs) or isolated neural lobes (NLs) of the rat pituitary gland were incubated in Krebs-HEPES solution which contained pargyline and the dopamine uptake inhibitor GBR 12921. The release of endogenous dopamine was determined by HPLC with electrochemical detection. Electrical stimulation of the pituitary stalk induced a frequency-dependent release of dopamine.The release of dopamine from the combined NIL evoked by stimulation at 15 Hz was increased by 130% in the presence of the dopamine D2 receptor antagonist, (–)-sulpiride; the (+)-enantiomer of sulpiride had virtually no effect. When the stimulation frequency was 3 Hz (–)-sulpiride caused an increase in dopamine release by 230%. A similar increase was observed in the presence of domperidone, another dopamine D2 receptor antagonist.The dopamine receptor agonists, apomorphine and quinpirole, had no significant effects on the evoked release of dopamine indicating that under the present incubation conditions endogenous dopamine may have been maximally activating the autoinhibition. However, in the presence of 1 mol/l (–)-sulpiride, apomorphine as well as quinpirole reduced the evoked release of dopamine in a concentration-dependent manner.The dopamine D1 receptor selective antagonist, SCH 23390, had no effect on the evoked release of dopamine at a concentration of 1 mol/1. Only at a concentration of 10 mol/l did SCH 23390 cause a small increase in dopamine release; this effect was, however, abolished in the presence of 1 mol/1(–)-sulpiride.In the presence of 1 mol/l (–)-sulpiride neither clonidine, yohimbine, 5-methoxytryptamine nor metitepine significantly affected the release of dopamine from the NIL evoked by stimulation at 3 Hz.In the NL, the release of dopamine is inhibited by endogenous opioids. For this reason, naloxone 1 or 10 mol/1 was present in the experiments on isolated NLs. Domperidone and (–)-sulpiride, but not (+)-sulpiride, increased the release of dopamine from the NL evoked by electrical stimulation at 15 Hz by about 90%. SCH 23390 caused a significant increase in dopamine release at 10 mol/l, but not at 1 mol/lIn conclusion, the release of endogenous dopamine from the neurons terminating in the intermediate and neural lobe of the pituitary gland is inhibited via dopamine receptors of the D2 type.Abbreviations DOPAC dihydroxyphenylacetic acid - 5-HT 5-hydroxytryptamine - HPLC high performance liquid chromatography - IL intermediate lobe - NIL neurointermediate lobe - NL neurallobe Send offprint requests to K. Racké at the above address     

Deposition of amyloid β protein in non-Alzheimer dementias: evidence for a neuronal origin of parenchymal deposits of β protein in neurodegenerative disease

Summary In two elderly patients with frontal lobe dementia and in two others with progressive aphasia an inverse relationship between the severity of protein deposition and the principal pathology of these disorders was noted. Deposition of protein occurred only in areas of cortex where functional (viable) neurones were still present and was absent where neuronal decimation had taken place. Such findings suggest that the presence of functional neurones is necessary for protein deposition to occur and, therefore, that neurones may be the source of the amyloid protein that is deposited within brain parenchyma not only in these disorders but also in other conditions, particularly Alzheimer's disease.Supported by a grant from the North Western Regional Health Authority (DJ) and a B.Sc Intercalated Studentship from the MRC (PWS)     

A Study of Epileptiform Hippocampal Unit Activity Induced by Intracerebroventricular Injection of Kainic Acid in Rats

Hippocampal EEG and unit activities were recorded after seizures were initiated withintracerebroventricular injection of kainic acid (KA) in rats. Three kinds of hippocampal unit re-sponses to KA were found:1. Positive units: These units were characterized by high frequency burst firing temporally coincidentwith each hippocampal EEG spike.2. Negative units: These units showed a cessation of firing during each EEG paroxysm.3. Indifferent units: These units showed no evident chanses coincident with EEG paroxysms.Most positive units were hippocampal complex spike cells which correspond histologically tohippocampal pyramidal cells, and most complex spike cells fired in positive bursts after KA treat-ment. In the early period after KA injection, the positive units were concentrated in CA3 area. It was suggested that the activities of positive units may be considered as the typical epileptiformhippocampal unit activity induced by KA, and the firing features of negative units ma be the resultof the influence of hippocampal inhibitory interneurons or the result of excessive cellulardepolarization, and that hippocampal pyramidal cells were more sensitive to the epileptogenic ef-fect of KA than hippocampal intemeurons, and some pyramidal cells in CA3, in particular,may serve as "epileptic pacemaker neurons " in KA-induced epileptogenesis.     

Analysis of the four heart sounds statistical study and spectro-temporal characteristics

Abstract

Heart auscultation has been recognised for a long time as an important tool for the diagnosis of heart disease; it is the most common and widely recommended method to screen for structural abnormalities of the cardiovascular system. Detecting relevant characteristics and forming a diagnosis based on the sounds heard through a stethoscope, however, is a skill that can take years to be acquired and refine. The efficiency and accuracy of diagnosis based on heart sound auscultation can be improved considerably by using digital signal processing techniques to analyse phonocardiographic (PCG) signals. The study of the functioning of the heart is very important for the diagnosis of different cardiac pathologies. The phonocardiogram signal (PCG) is the signal generated after conversion of the sound noises coming from the heart into an electrical signal, it groups together a set of four cardiac noises (S1, S2, S3, S4) which are in direct correlation with cardiac activity. The short-term Fourier Transform (STFT) is an analytical technique that describes the evolution of the time and frequency behaviour of these four heart sounds. A statistical study has been carried out in this direction in order to better highlight the characteristics of the PCG signal. A fairly high number of cycles (twenty) was used to further refine the expected results. The objective of this paper is to use a statistical analysis based on the results obtained by the use of The STFT technic this in order to find statistical parameters (mean, standard deviation, etc.) which can give us a clear vision of the electrophysiological behaviour of the phonocardiogram signal. This aspect has not been done so far and which however can give appreciable practical results.     

发作间期PET和SPECT检查对颞叶癫痫定位的诊断价值

目的：探讨发作间期１８Ｆ脱氧葡萄糖（ＦＤＧ）正电子发射断层扫描（ＰＥＴ）和９９ｍＴｃ已撑半胱氨酸（ＥＣＤ）单光子发射断层扫描（ＳＰＥＣＴ）对难治性颞叶癫痫（ＴＬＥ）的定位诊断价值。方法：５３例脑电图（ＥＥＧ）定位明确的难治性ＴＬＥ患者分别行发作间期１８ＦＦＤＧＰＥＴ和９９ｍＴｃＥＣＤＳＰＥＣＴ检查。其中２１例磁共振（ＭＲＩ）显示有结构性病变并与ＥＥＧ定位结果一致。结果：ＭＲＩ异常组均在ＰＥＴ和ＳＰＥＣＴ相应部位出现低代谢和低灌注表现。ＭＲＩ正常组，ＰＥＴ定位准确率为８４％，显著高于ＳＰＥＣＴ的５６％（Ｐ＜００５）。结论：对于无结构性病变的颞叶癫痫，发作间期ＰＥＴ检查有较高的定位诊断价值，ＳＰＥＣＴ的临床意义相对较小。     

肝尾状叶的外科解剖及其临床应用

在42例成人肝脏标本上，研究了肝尾状叶的形态，动脉、静脉和肝管的分布特征；尾状叶常有3个突起，即尾状突、乳头突和下腔静脉后突，且变异较大；尾状叶有两个恒定的蒂，其结构排列由浅入深分别是门静脉支、肝动脉支和肝管。尾状叶静脉有2～5支，其中以3支居多，主要汇入下腔静脉肝后段的中、下1／3部的左前壁。中结合解剖学研究总结了施行肝尾状叶肿瘤切除术的方法和经验。     

CACNA1H基因G773D突变对钙通道功能的影响

目的研究儿童失神癫痫（childhood absence epilepsy，CAE）患儿CACNA1H基因G773D突变对钙通道功能的影响。方法用定点突变重叠延伸聚合酶链反应（polymerase chain reaction，PCR）方法构建G773D突变体，脂质体法将突变体和野生型人Cav3．2a cDNA分别转染HEK-293细胞，获得稳定表达细胞株，全细胞膜片钳法研究其电生理变化。结果突变体和野生型细胞钙通道激活和失活动力学差异无统计学意义，但突变体G773D钙电流密度明显高于野生型。结论CACNA1H基因G773D突变可使其编码通道电流增加，并可能引起神经元兴奋性增加。