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Quigg M, Bonnie R, Bauer D, Goodkin HP, Kapur J. A medico-legal perspective on postictal violence: A case study and systematic review of postictal delirium. Epilepsy Res 2024; 205:107398. [PMID: 38976952 DOI: 10.1016/j.eplepsyres.2024.107398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/24/2024] [Accepted: 06/27/2024] [Indexed: 07/10/2024]
Abstract
Detailed descriptions of violent postictal episodes are rare. We provide evidence from an index case and from a systematic review of violent postictal episodes that demonstrates the encephalopathic features of some violent postictal behaviors. We discuss how these cases may fit in the legal framework of culpability. The data support the view that some episodes of violent postictal behavior are more accurately classified as a neurological delirium or encephalopathy rather than as a postictal psychosis. Current medical terminology may present unwarranted (and presumably unintended) barriers to exculpation for patients who exhibit post-ictal violence during an episode of delirium during which the patient was unaware of his or her violent conduct.
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Affiliation(s)
- Mark Quigg
- Department of Neurology, School of Medicine, University of Virginia, Charlottesville, VA, United States.
| | - Richard Bonnie
- School of Law, University of Virginia, Charlottesville, VA, United States
| | - Derek Bauer
- Department of Neurology, University of Rochester, Rochester, NY, United States
| | - Howard P Goodkin
- Department of Neurology, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Jaideep Kapur
- Department of Neurology, School of Medicine, University of Virginia, Charlottesville, VA, United States
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2
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Bartolomei F, Bratu IF. Status epilepticus and psychosis: Lessons from SEEG. Epilepsy Behav 2024; 158:109911. [PMID: 38924969 DOI: 10.1016/j.yebeh.2024.109911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/16/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024]
Abstract
Psychotic manifestations are a classic feature of non-convulsive status epilepticus (NCSE) of temporal origin. For several decades now, the various psychiatric manifestations of NCSE have been described, and in particular, the diagnostic challenges they pose. However, studies using stereotactic-EEG (SEEG) recordings are very rare. Only a few cases have been reported, but they demonstrated the anatomical substrate of certain manifestations, including hallucinations, delusions, and emotional changes. The post-ictal origin of some of the manifestations should be emphasized. More generally, SEEG has shown that seizures affecting the temporal and frontal limbic systems can lead to intense emotional experiences and behavioural disturbances.
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Affiliation(s)
- Fabrice Bartolomei
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France.
| | - Ionuț-Flavius Bratu
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France
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Datta AN. A video case vignette: Hypermotor activity, ictal aggression, and bolting in an adolescent with an anteromedial temporal lesion. Epileptic Disord 2024; 26:236-239. [PMID: 37971030 DOI: 10.1002/epd2.20176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
Content available: Video.
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Affiliation(s)
- Anita N Datta
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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4
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Beniczky S, Tatum WO, Blumenfeld H, Stefan H, Mani J, Maillard L, Fahoum F, Vinayan KP, Mayor LC, Vlachou M, Seeck M, Ryvlin P, Kahane P. Seizure semiology: ILAE glossary of terms and their significance. Epileptic Disord 2022; 24:447-495. [PMID: 35770761 DOI: 10.1684/epd.2022.1430] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/19/2022] [Indexed: 11/17/2022]
Abstract
This educational topical review and Task Force report aims to address learning objectives of the International League Against Epilepsy (ILAE) curriculum. We sought to extract detailed features involving semiology from video recordings and interpret semiological signs and symptoms that reflect the likely localization for focal seizures in patients with epilepsy. This glossary was developed by a working group of the ILAE Commission on Diagnostic Methods incorporating the EEG Task Force. This paper identifies commonly used terms to describe seizure semiology, provides definitions, signs and symptoms, and summarizes their clinical value in localizing and lateralizing focal seizures based on consensus in the published literature. Video-EEG examples are included to illustrate important features of semiology in patients with epilepsy.
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Kanth KM, Zimmerman CS, Toprani SC, Seyal M. Duration of postictal impaired awareness after bilateral tonic-clonic seizures: EEG and patient characteristics. Epilepsy Behav 2022; 128:108576. [PMID: 35123240 DOI: 10.1016/j.yebeh.2022.108576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/02/2022] [Accepted: 01/13/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Ictal and postictal phenomena that may impact the duration of postictal impaired awareness have not been well studied. Postictal unresponsiveness invariably occurs following bilateral tonic-clonic seizures (BTCS). Bilateral tonic-clonic seizures are a major risk factor for sudden unexpected death in epilepsy (SUDEP). We quantify the effects of seizure characteristics on postictal recovery of awareness following BTCS. Factors include: the total seizure duration, the duration of the tonic phase of a BTCS, presence of postictal generalized EEG suppression (PGES), duration of postictal tonic electromyographic discharge, peri-ictal respiratory dysfunction, patient age, duration of epilepsy, and gender. METHODS Fifty-eight patients admitted to the epilepsy monitoring unit with BTCS were studied. Forty-one had unilateral onset temporal seizures. The remainder had bitemporal onsets, extratemporal onsets, undetermined onsets, or were generalized at onset. Following the first BTCS, time to initial recovery of awareness and its possible association with patient and seizure characteristics as well as peri-ictal respiratory dysfunction were evaluated. The presence or absence of postictal agitation was noted. RESULTS The severity of respiratory dysfunction and seizure characteristics were not associated with time to initial recovery of awareness. A shorter time to recovery of awareness was significantly associated with a younger age (p = 0.007). Postictal agitation was more common in males (p = 0.023). SIGNIFICANCE Focal seizures may impair awareness by active inhibition of subcortical arousal mechanisms. Focal seizures progressing to bilateral tonic-clonic seizures (BTCS) result in further widespread cerebral dysfunction impacting postictal awareness. MRI studies show accelerated brain aging in patients with temporal lobe epilepsy. Our findings suggest that patient age, as a surrogate marker for the lifetime burden of seizures, results in a progressive worsening in time to recovery after BTCS by an increasing negative impact on networks involved in arousal.
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Affiliation(s)
- Kiran M Kanth
- Department of Neurology, University of California, Davis, United States
| | | | - Sheela C Toprani
- Department of Neurology, University of California, Davis, United States
| | - Masud Seyal
- Department of Neurology, University of California, Davis, United States.
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Prefrontal seizure classification based on stereo-EEG quantification and automatic clustering. Epilepsy Behav 2020; 112:107436. [PMID: 32906017 DOI: 10.1016/j.yebeh.2020.107436] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE Frontal seizures are organized according to anatomo-functional subdivisions of the frontal lobe. Prefrontal seizures have been the subject of few detailed studies to date. The objective of this study was to identify subcategories of prefrontal seizures based on seizure onset quantification and to look for semiological differences. METHODS Consecutive patients who underwent stereoelectroencephalography (SEEG) for drug-resistant prefrontal epilepsy between 2000 and 2018 were included. The different prefrontal regions investigated in our patients were dorsolateral prefrontal cortex (DLPFC), ventrolateral prefrontal cortex (VLPFC), dorsomedial prefrontal cortex (DMPFC), ventromedial prefrontal cortex (VMPFC), and orbitofrontal cortex (OFC). The seizure onset zone (SOZ) was determined from one or two seizures in each patient, using the epileptogenicity index (EI) method. The presence or absence of 16 clinical ictal manifestations was analyzed. Classification of prefrontal networks was performed using the k-means automatic classification method. RESULTS A total of 51 seizures from 31 patients were analyzed. The optimal clustering was 4 subgroups of prefrontal seizures: a "pure DLPF" group, a "pure VMPF" group, a "pure OFC" group, and a "global prefrontal" group. The first 3 groups showed a mean EI considered epileptogenic (>0.4) only in one predominant structure, while the fourth group showed a high mean EI in almost all prefrontal structures. The median number of epileptogenic structures per seizure (prefrontal or extrafrontal) was 5 for the "global prefrontal" group and 2 for the other groups. We found that the most common signs were altered consciousness, automatisms/stereotypies, integrated gestural motor behavior, and hyperkinetic motor behavior. We found no significant difference in the distribution of ictal signs between the different groups. CONCLUSION Our study showed that although most prefrontal seizures manifest as a network of several anatomically distinct structures, we were able to determine a sublobar organization of prefrontal seizure onset with four groups.
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Fayerstein J, McGonigal A, Pizzo F, Bonini F, Lagarde S, Braquet A, Trébuchon A, Carron R, Scavarda D, Julia S, Lambert I, Giusiano B, Bartolomei F. Quantitative analysis of hyperkinetic seizures and correlation with seizure onset zone. Epilepsia 2020; 61:1019-1026. [DOI: 10.1111/epi.16510] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/11/2020] [Accepted: 03/31/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Julie Fayerstein
- National Institute of Health and Medical Research Institute of Systems Neuroscience Aix Marseille University Marseille France
- Epileptology Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Aileen McGonigal
- National Institute of Health and Medical Research Institute of Systems Neuroscience Aix Marseille University Marseille France
- Epileptology Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Francesca Pizzo
- National Institute of Health and Medical Research Institute of Systems Neuroscience Aix Marseille University Marseille France
- Epileptology Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Francesca Bonini
- National Institute of Health and Medical Research Institute of Systems Neuroscience Aix Marseille University Marseille France
- Epileptology Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Stanislas Lagarde
- National Institute of Health and Medical Research Institute of Systems Neuroscience Aix Marseille University Marseille France
- Epileptology Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Aurore Braquet
- Epileptology Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Agnès Trébuchon
- Epileptology Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Romain Carron
- Functional and Stereotactic Neurosurgery Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Didier Scavarda
- Pediatric Neurosurgery Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Scholly Julia
- Epileptology Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Isabelle Lambert
- National Institute of Health and Medical Research Institute of Systems Neuroscience Aix Marseille University Marseille France
- Epileptology Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Bernard Giusiano
- National Institute of Health and Medical Research Institute of Systems Neuroscience Aix Marseille University Marseille France
- Epileptology Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
| | - Fabrice Bartolomei
- National Institute of Health and Medical Research Institute of Systems Neuroscience Aix Marseille University Marseille France
- Epileptology Department Timone Hospital Public Assistance Hospitals of Marseille Marseille France
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Danish N, Khawaja IS, Schenck CH. Violent Parasomnia With Recurrent Biting and Surgical Interventions: Case Report and Differential Diagnosis. J Clin Sleep Med 2018; 14:889-891. [PMID: 29734991 DOI: 10.5664/jcsm.7134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 11/13/2022]
Abstract
ABSTRACT A case is reported of recurrent, injurious self-biting during sleep, requiring surgical interventions, in a 55-year-old obese man with a 20-year history of violent complex parasomnia, with greatly increased frequency and severity of episodes induced by work stress during the preceding 3 years. After clinical evaluation and overnight, hospital-based video-polysomnography, the cause of the chronic injurious parasomnia was deemed to be a non-rapid eye movement (NREM) sleep parasomnia comorbid with severe obstructive sleep apnea. Therapy with bedtime clonazepam and bilevel positive airway pressure was effective, with injurious parasomnia relapse occurring with cessation of either or both of these therapies. The differential diagnosis of sleep-related biting should now include NREM sleep parasomnia (with or without comorbid obstructive sleep apnea), besides previously reported cases of REM sleep behavior disorder (RBD), sleep-related dissociative disorder, sleep-related rhythmic movement disorder and anticipated cases of parasomnia overlap disorder (RBD + NREM sleep parasomnia), sleep-related biting seizures, and sleep-related eating disorder.
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Affiliation(s)
- Nilam Danish
- Center for Sleep Medicine, Department of Neurology, VA Medical Center, Dallas, Texas
| | - Imran S Khawaja
- Center for Sleep Medicine, Department of Neurology, VA Medical Center, Dallas, Texas.,Department of Psychiatry and Neurology and Neurotherapeutics, UTSW Medical Center, Dallas, Texas
| | - Carlos H Schenck
- Minnesota Regional Sleep Disorders Center, Departments of Psychiatry, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis, Minnesota
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Azuar C, Levy R. Behavioral disorders: The ‘blind spot’ of neurology and psychiatry. Rev Neurol (Paris) 2018; 174:182-189. [DOI: 10.1016/j.neurol.2018.02.083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/16/2018] [Accepted: 02/20/2018] [Indexed: 11/25/2022]
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Menghi V, Bisulli F, Tinuper P, Nobili L. Sleep-related hypermotor epilepsy: prevalence, impact and management strategies. Nat Sci Sleep 2018; 10:317-326. [PMID: 30349413 PMCID: PMC6186898 DOI: 10.2147/nss.s152624] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Sleep-related hypermotor epilepsy (SHE), previously called nocturnal frontal lobe epilepsy (NFLE), is a focal epilepsy characterized by asymmetric tonic/dystonic posturing and/or complex hyperkinetic seizures occurring mostly during sleep. SHE fulfills the definition of rare disease with an estimated minimum prevalence of 1.8/100,000 individuals, and it represents about 10% of drug-resistant surgical cases. Although SHE and autosomal-dominant SHE (ADSHE) have been considered benign epileptic conditions for a long time, emerging data have shed light on the severity of this disorder and some peculiar features can impact negatively on the quality of life of SHE patients. In fact, seizure frequency can be very high, resulting in nocturnal sleep fragmentation with possible diurnal consequences such as excessive sleepiness and fatigue. Moreover, recent studies, adopting a systematic neuropsychological assessment, have shown deficits in memory, executive functions and visuo-spatial abilities in almost half of SHE patients. Intellectual disabilities and psychiatric disorders have also been reported in some genetic forms. SHE may also exert a negative effect on health-related quality of life, especially in domains pertaining to a patient's role in the family, social context and patient's illness experience. Despite a good response to pharmacological treatment, especially with carbamazepine, 30% of SHE patients suffer from drug-resistant seizures. Finally, recent studies suggest a poor prognosis in a high percentage of SHE patients with a 20.4% cumulative probability of achieving terminal remission at 10 years from onset. For selected drug-resistant SHE patients, epilepsy surgery is the only treatment offering high probability of recovery, both for seizures and for epilepsy-related sleep alterations.
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Affiliation(s)
- Veronica Menghi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Francesca Bisulli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Paolo Tinuper
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Lino Nobili
- "Claudio Munari" Center for Epilepsy Surgery, Niguarda Hospital, Milan, Italy, .,Department of Neuroscience (DINOGMI), IRCCS, Giannina Gaslini Institute, University of Genoa, Genoa, Italy,
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11
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Rektor I, Schachter SC, Arya R, Arzy S, Braakman H, Brodie MJ, Brugger P, Chang BS, Guekht A, Hermann B, Hesdorffer DC, Jones-Gotman M, Kanner AM, Garcia-Larrea L, Mareš P, Mula M, Neufeld M, Risse GL, Ryvlin P, Seeck M, Tomson T, Korczyn AD. Third International Congress on Epilepsy, Brain, and Mind: Part 2. Epilepsy Behav 2015; 50:138-59. [PMID: 26264466 DOI: 10.1016/j.yebeh.2015.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 07/07/2015] [Indexed: 01/01/2023]
Abstract
Epilepsy is both a disease of the brain and the mind. Here, we present the second of two papers with extended summaries of selected presentations of the Third International Congress on Epilepsy, Brain and Mind (April 3-5, 2014; Brno, Czech Republic). Humanistic, biologic, and therapeutic aspects of epilepsy, particularly those related to the mind, were discussed. The extended summaries provide current overviews of epilepsy, cognitive impairment, and treatment, including brain functional connectivity and functional organization; juvenile myoclonic epilepsy; cognitive problems in newly diagnosed epilepsy; SUDEP including studies on prevention and involvement of the serotoninergic system; aggression and antiepileptic drugs; body, mind, and brain, including pain, orientation, the "self-location", Gourmand syndrome, and obesity; euphoria, obsessions, and compulsions; and circumstantiality and psychiatric comorbidities.
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Affiliation(s)
- Ivan Rektor
- Masaryk University, Brno Epilepsy Center, St. Anne's Hospital and School of Medicine and Central European Institute of Technology (CEITEC), Brno, Czech Republic
| | - Steven C Schachter
- Consortia for Improving Medicine with Innovation and Technology, Harvard Medical School, Boston, MA, USA.
| | - Ravindra Arya
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Shahar Arzy
- Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hilde Braakman
- Academic Center for Epileptology, Kempenhaeghe & Maastricht UMC, Sterkselseweg 65, 5591 VE Heeze, The Netherlands
| | | | - Peter Brugger
- Neuropsychology Unit, Department of Neurology, University Hospital Zürich, Zurich, Switzerland
| | - Bernard S Chang
- Departments of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Alla Guekht
- Russian National Research Medical University, Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Bruce Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Dale C Hesdorffer
- Gertrude H. Sergievsky Center and Department of Epidemiology, Columbia University, NY, USA
| | - Marilyn Jones-Gotman
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Andres M Kanner
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Luis Garcia-Larrea
- NeuroPain Lab, Centre for Neuroscience of Lyon, Inserm U1028, Hôpital Neurologique, 59Bd Pinel 69003 Lyon, France
| | - Pavel Mareš
- Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Marco Mula
- Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital & Institute of Medical and Biomedical Sciences, St George's University of London, London, UK
| | - Miri Neufeld
- EEG and Epilepsy Unit, Department of Neurology, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Philippe Ryvlin
- Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland; TIGER, Lyon's Neuroscience Research Center, INSERM U1028, CNRS5292 Lyon, France
| | - Margitta Seeck
- Neurology Service, Hòpitaux Universitaires de Genève, Genève, Switzerland
| | - Torbjörn Tomson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Amos D Korczyn
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
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12
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The functional profile of the human amygdala in affective processing: Insights from intracranial recordings. Cortex 2014; 60:10-33. [DOI: 10.1016/j.cortex.2014.06.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 01/30/2014] [Accepted: 06/04/2014] [Indexed: 11/21/2022]
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13
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Surgical treatment of hypermotor seizures originating from the temporal lobe. Seizure 2013; 22:862-6. [DOI: 10.1016/j.seizure.2013.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 07/14/2013] [Accepted: 07/16/2013] [Indexed: 11/22/2022] Open
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Lit L, Belanger JM, Boehm D, Lybarger N, Haverbeke A, Diederich C, Oberbauer AM. Characterization of a dopamine transporter polymorphism and behavior in Belgian Malinois. BMC Genet 2013; 14:45. [PMID: 23718893 PMCID: PMC3680094 DOI: 10.1186/1471-2156-14-45] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 05/22/2013] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The Belgian Malinois dog breed (MAL) is frequently used in law enforcement and military environments. Owners have reported seizures and unpredictable behavioral changes including dogs' eyes "glazing over," dogs' lack of response to environmental stimuli, and loss of behavioral inhibition including owner-directed biting behavior. Dogs with severe behavioral changes may be euthanized as they can represent a danger to humans and other dogs. In the dog, the dopamine transporter gene (DAT) contains a 38-base pair variable number tandem repeat (DAT-VNTR); alleles have either one or two copies of the 38-base pair sequence. The objective of this study was to assess frequency of DAT-VNTR alleles, and characterize the association between DAT-VNTR alleles and behavior in MAL and other breeds. RESULTS In an American sample of 280 dogs comprising 26 breeds, most breeds are predominantly homozygous for the DAT-VNTR two-tandem-repeat allele (2/2). The one-tandem-repeat allele is over-represented in American MAL (AM-MAL) (n = 144), both as heterozygotes (1/2) and homozygotes (1/1). All AM-MAL with reported seizures (n = 5) were 1/1 genotype. For AM-MAL with at least one "1" allele (1/1 or 1/2 genotype, n = 121), owners reported higher levels of attention, increased frequency of episodic aggression, and increased frequency of loss of responsiveness to environmental stimuli. In behavior observations, Belgian Military Working Dogs (MWD) with 1/1 or 1/2 genotypes displayed fewer distracted behaviors and more stress-related behaviors such as lower posture and increased yawning. Handlers' treatment of MWD varied with DAT-VNTR genotype as did dogs' responses to handlers' behavior. For 1/1 or 1/2 genotype MWD, 1) lower posture after the first aversive stimulus given by handlers was associated with poorer obedience performance; 2) increased aversive stimuli during protection exercises were associated with decreased performance; 3) more aversive stimuli during obedience were associated with more aversive stimuli during protection; and 4) handlers used more aversive stimuli in protection compared with obedience exercises. CONCLUSIONS The single copy allele of DAT-VNTR is associated with owner-reported seizures, loss of responsiveness to environmental stimuli, episodic aggression, and hyper-vigilance in MAL. Behavioral changes are associated with differential treatment by handlers. Findings should be considered preliminary until replicated in a larger sample.
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Affiliation(s)
- Lisa Lit
- Department of Animal Science, University of California Davis, Davis, CA 95616, USA.
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Larisa Fabres O. Violencia durante el sueño. REVISTA MÉDICA CLÍNICA LAS CONDES 2013. [DOI: 10.1016/s0716-8640(13)70183-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Abstract
The relationships between biological rhythms and human aggressive behavior are addressed and discussed in this article: First, circadian rhythms and aggression are considered. Studies of sleep/waking cycle disturbances in aggression are reported. Severe aggression is associated with profound changes in sleep architecture. Causal link is difficult to establish given that sleep disturbance and aggressive behavior could be the symptoms of the same disorder. Specific aggressive behavior developed during sleep is also described. In addition, hormonal circadian rhythm studies are reported. Thus, low cortisol levels, in particular low cortisol variability, are associated with aggressive behavior, suggesting an inhibitory role of cortisol. Testosterone has daily and seasonal fluctuations, but no link with aggression has been established. Neurophysiological underlying mechanisms are discussed in the last part of this article, with a focus on the relationship between brain rhythm and aggression. Increase of slow-wave EEG activities is observed in individuals with aggressive behavior. Epilepsy, as a disease of brain rhythm could be associated with aggressive behavior, in pre, post and inter ictal periodes. Incidence of aggression is not likely more prevalent in epileptic individuals compared to those with other neurological conditions. Ictal changes take the form of profound behavioral changes, including aggressive behavior which has been interpreted as the emergence of "archeical" or innate motor patterns. In this multidisciplinary approach, the main difficulty is the categorization of the differents types of aggression. Finally, taken together, these studies suggest that biological rhythms, especially circadian rhythms, could provide therapeutic benefits to human aggressive behavior. Biological rhythymicity seems to be a necessary permanent training offering interesting perspectives for the adaptation to changes in the field of aggression.
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Tassinari CA, Gardella E, Cantalupo G, Rubboli G. Relationship of Central Pattern Generators with Parasomnias and Sleep-Related Epileptic Seizures. Sleep Med Clin 2012. [DOI: 10.1016/j.jsmc.2012.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Deriaz N, Willi JP, Orihuela-Flores M, Galli Carminati G, Ratib O. Treatment with levetiracetam in a patient with pervasive developmental disorders, severe intellectual disability, self-injurious behavior, and seizures: a case report. Neurocase 2012; 18:386-91. [PMID: 22059937 DOI: 10.1080/13554794.2011.627336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Pervasive developmental disorder is characterized by various symptoms that often include self-injurious behavior (SIB). Episodes of SIB occur in the context of high emotional arousal, anger, or fear and may be related to epilepsy. We report the case of a 20-year-old man with pervasive developmental disorder presenting with SIB non-responsive to antipsychotic medication. Positron emission tomography showed a right temporoparietal hypometabolic focal lesion suggestive of an epileptic focus. Two weeks after initiation of levetiracetam (Keppra®), SIB disappeared, without recurrence 24 months later. Levetiracetam (Keppra®) may be beneficial for such patients.
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Affiliation(s)
- N Deriaz
- Department of Psychiatry, Mental Development Psychiatric Unit, Service of Adult Psychiatry, Geneva University Hospitals, Geneva, Switzerland
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19
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A new Italian instrument for the assessment of irritability in patients with epilepsy. Epilepsy Behav 2011; 21:275-81. [PMID: 21624849 DOI: 10.1016/j.yebeh.2011.04.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 04/11/2011] [Accepted: 04/14/2011] [Indexed: 11/22/2022]
Abstract
The purpose of the work described in this article was to analyze the psychometric properties of a new Italian instrument for the assessment of irritability in adult patients with epilepsy (I-Epi). Five hundred four patients from nine secondary and tertiary Italian centers for the care of epilepsy were recruited and interviewed. Each patient was evaluated on a series of demographic and clinical variables recorded before administration of the I-Epi and the AQ (Aggression Questionnaire), used for external validity. The final results supported the reliability and validity of the I-Epi as a measure of irritability in the adult epilepsy population. The psychometric characteristics of the I-Epi seemed fairly good. We believe that adoption of this new instrument could be very useful in both clinical and research management of patients with epilepsy.
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Granieri E, Fazio P. The Lombrosian prejudice in medicine. The case of epilepsy. Epileptic psychosis. Epilepsy and aggressiveness. Neurol Sci 2011; 33:173-92. [PMID: 21538126 DOI: 10.1007/s10072-011-0568-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 03/19/2011] [Indexed: 11/28/2022]
Abstract
In the nineteenth century, epilepsy became subject of experimental research. Lombroso established a relationship between epilepsy and criminality believing in the existence of epileptoid traits and atavism. He tried to demonstrate the common origin of epilepsy, criminality, and genius; factors deteriorating the CNS would act upon centers, which control behavior and ethics. This impairment would cause a lack of control on the lower nervous centers, reducing restraints of instincts and criminal behavior. He described developmental frontal cortex lesions in epileptic patients (today Taylor's dysplasia) and these observations supported the erroneous conviction of a relationship between criminality and epilepsy. Neurological, behavioral, and criminological sciences analyzed Lombroso's doctrine, whereas it was controversial that epileptic patients should be prone to violent actions and aggressive behavior. Today, there is an international panel of experts on epilepsy, which suggests five relevant criteria to determine if a crime committed with aggressiveness could result from epileptic seizures.
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Affiliation(s)
- Enrico Granieri
- Department of Medical, Surgical Sciences of Communication and Behavior, Section of Neurology, University of Ferrara, Italy, Corso della Giovecca 203, 44100 Ferrara, Italy.
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Siclari F, Khatami R, Urbaniok F, Nobili L, Mahowald MW, Schenck CH, Cramer Bornemann MA, Bassetti CL. Violence in sleep. Brain 2010; 133:3494-509. [DOI: 10.1093/brain/awq296] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Tassinari C, Cantalupo G, Högl B, Cortelli P, Tassi L, Francione S, Nobili L, Meletti S, Rubboli G, Gardella E. Neuroethological approach to frontolimbic epileptic seizures and parasomnias: The same central pattern generators for the same behaviours. Rev Neurol (Paris) 2009; 165:762-8. [DOI: 10.1016/j.neurol.2009.08.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cannon R, Lubar J, Sokhadze E, Baldwin D. LORETA Neurofeedback for Addiction and the Possible Neurophysiology of Psychological Processes Influenced: A Case Study and Region of Interest Analysis of LORETA Neurofeedback in Right Anterior Cingulate Cortex. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/10874200802501948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rheims S, Ryvlin P, Scherer C, Minotti L, Hoffmann D, Guenot M, Mauguière F, Benabid AL, Kahane P. Analysis of clinical patterns and underlying epileptogenic zones of hypermotor seizures. Epilepsia 2008; 49:2030-40. [DOI: 10.1111/j.1528-1167.2008.01675.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Self-injurious behavior and tuberous sclerosis complex: frequency and possible associations in a population of 257 patients. Epilepsy Behav 2008; 13:650-3. [PMID: 18703161 DOI: 10.1016/j.yebeh.2008.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Revised: 07/21/2008] [Accepted: 07/26/2008] [Indexed: 12/14/2022]
Abstract
Self-injurious behavior (SIB) has been observed in people with tuberous sclerosis complex (TSC), although the frequency of SIB in TSC is largely unknown. SIB is associated with intellectual and developmental disabilities, but there is no single cause of SIB. We retrospectively examined the frequency of SIB in a population of 257 patients with TSC and determined possible associations with SIB. We found a 10% frequency of SIB in our TSC population. When compared with patients without psychiatric symptoms, we identified a significantly higher rate of electroencephalographic interictal spikes in the left frontal lobe and a significantly lower number of tubers in the left occipital, parietal, and posterior temporal lobes. We also found that frequency of TSC2 mutation, history of infantile spasms, history of seizures, mental retardation, and autism are significantly associated with SIB.
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Abstract
In the present work, we investigated whether an auditory peripersonal space exists around the hand and whether such a space might be extended by a brief tool-use experience or by long-term experience using a tool in everyday life. To this end, we studied audio-tactile integration in the space around the hand and in far space, in blind subjects who regularly used a cane to navigate and in sighted subjects, before and after brief training with the cane. In sighted subjects, auditory peripersonal space was limited to around the hand before tool use, then expanded after tool use, and contracted backward after a resting period. In contrast, in blind subjects, peri-hand space was immediately expanded when they held the cane but was limited to around the hand when they held a short handle. These results suggest that long-term experience with the cane induces a durable extension of the peripersonal space.
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Affiliation(s)
- Andrea Serino
- Dipartimento di Psicologia, Universitaà degli Studi di Bologna, Bologna, Italy.
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Parrino L, Halasz P, Tassinari CA, Terzano MG. CAP, epilepsy and motor events during sleep: the unifying role of arousal. Sleep Med Rev 2006; 10:267-85. [PMID: 16809057 DOI: 10.1016/j.smrv.2005.12.004] [Citation(s) in RCA: 137] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Arousal systems play a topical neurophysiologic role in protecting and tailoring sleep duration and depth. When they appear in NREM sleep, arousal responses are not limited to a single EEG pattern but are part of a continuous spectrum of EEG modifications ranging from high-voltage slow rhythms to low amplitude fast activities. The hierarchic features of arousal responses are reflected in the phase A subtypes of CAP (cyclic alternating pattern) including both slow arousals (dominated by the <1Hz oscillation) and fast arousals (ASDA arousals). CAP is an infraslow oscillation with a periodicity of 20-40s that participates in the dynamic organization of sleep and in the activation of motor events. Physiologic, paraphysiologic and pathologic motor activities during NREM sleep are always associated with a stereotyped arousal pattern characterized by an initial increase in EEG delta power and heart rate, followed by a progressive activation of faster EEG frequencies. These findings suggest that motor patterns are already written in the brain codes (central pattern generators) embraced with an automatic sequence of EEG-vegetative events, but require a certain degree of activation (arousal) to become visibly apparent. Arousal can appear either spontaneously or be elicited by internal (epileptic burst) or external (noise, respiratory disturbance) stimuli. Whether the outcome is a physiologic movement, a muscle jerk or a major epileptic attack will depend on a number of ongoing factors (sleep stage, delta power, neuro-motor network) but all events share the common trait of arousal-activated phenomena.
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Affiliation(s)
- Liborio Parrino
- Sleep Disorders Center, Department of Neuroscience, University of Parma, Via Gramsci, 14, 43100 Parma, Italy
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Millichap JG. Aggressive Biting Behavior and Seizures. Pediatr Neurol Briefs 2005. [DOI: 10.15844/pedneurbriefs-19-5-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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