Widespread activation of the brainstem preceding the recruiting rhythm in human epilepsies

Forebrain-independent generation of hyperthermic convulsions in infant rats

Febrile seizures are the most common type of convulsive events in children. It is generally assumed that the generalization of these seizures is a result of brainstem invasion by the initial limbic seizure activity. Using precollicular transection in 13‐day‐old rats to isolate the forebrain from the brainstem, we demonstrate that the forebrain is not required for generation of tonic–clonic convulsions induced by hyperthermia or kainate. Compared with sham‐operated littermate controls, latency to onset of convulsions in both models was significantly shorter in pups that had undergone precollicular transection, indicating suppression of the brainstem seizure network by the forebrain in the intact animal. We have shown previously that febrile seizures are precipitated by hyperthermia‐induced respiratory alkalosis. Here, we show that triggering of hyperthermia‐induced hyperventilation and consequent convulsions in transected animals are blocked by diazepam. The present data suggest that the role of endogenous brainstem activity in triggering tonic–clonic seizures should be re‐evaluated in standard experimental models of limbic seizures. Our work sheds new light on the mechanisms that generate febrile seizures in children and, therefore, on how they might be treated.

Fosphenytoin induced transient pendular nystagmus

Pendular nystagmus was seen after intravenous infusion of fosphenytoin for the treatment of breakthrough seizure. The oscillations were conjugate, quasi-sinusoidal, and regular. The nystagmus was resolved within 12h. Phenytoin is known to cause conduction slowing. Such delays in the feedback between the cerebellum and the oculomotor neural integrator may cause instability of the integrator. An improvement in the conduction delay following post-ictal recovery may resolve the pendular nystagmus.

Treatment of Bipolar, Seizure, and Sleep Disorders and Migraine Headaches Utilizing a Chiropractic Technique

OBJECTIVE

To discuss the use of an upper cervical technique in the case of a 23-year-old male patient with rapid-cycling bipolar disorder, sleep disorder, seizure disorder, neck and back pain, and migraine headaches.

CLINICAL FEATURES

The patient participated in a high school track meet at age 17, landing on his head from a height of 10 ft while attempting a pole vault. Prior to the accident, no health problems were reported. Following the accident, the patient developed numerous neurological disorders. Symptoms persisted over the next 6 years, during which time the patient sought treatment from many physicians and other health care practitioners.

INTERVENTION AND OUTCOME

At initial examination, evidence of a subluxation stemming from the upper cervical spine was found through thermography and radiography. Chiropractic care using an upper cervical technique was administered to correct and stabilize the patient's upper neck injury. Assessments at baseline, 2 months, and 4 months were conducted by the patient's neurologist. After 1 month of care, the patient reported an absence of seizures and manic episodes and improved sleep patterns. After 4 months of care, seizures and manic episodes remained absent and migraine headaches were reduced from 3 per week to 2 per month. After 7 months of care, the patient reported the complete absence of symptoms. Eighteen months later, the patient remains asymptomatic.

CONCLUSION

The onset of the symptoms following the patient's accident, the immediate reduction in symptoms correlating with the initiation of care, and the complete absence of all symptoms within 7 months of care suggest a link between the patient's headfirst fall, the upper cervical subluxation, and his neurological conditions. Further investigation into upper cervical trauma as a contributing factor to bipolar disorder, sleep disorder, seizure disorder, and migraine headaches should be pursued.