Epilepsy and behaviour

Keywords: Epileptic encephalopathy with continuous spike-and-wave during sleep Myoclonus Electrical status epilepticus during sleep Fixation-off sensitivity Atypical benign partial epilepsy Epileptic encephalopathy with continuous spike-and-wave during sleep is a rare age-related childhood encephalopathy characterized by neuropsychological and motor impairment, epilepsy, and typical EEG findings. Fixation-off sensitivity denotes forms of epilepsy and/or EEG abnormalities that occur during eye closure. The authors describe a girl with developmental regression, electrical status epilepticus during sleep (documented by video/EEG recording), and intermittent myoclonus. Her younger brother was diagnosed with atypical benign partial epilepsy, and his repeated video/EEG recordings unexpectedly showed fixation-off sensitivity.

The study was aimed at investigating perception of, attitudes toward, and knowledge of epilepsy among college students of the University of Messina in Sicily (Italy), high school students, and teachers from Sicily in order to structure health educational programs to remediate inadequate knowledge and stigma about epilepsy. Participants in this study consisted of 932 subjects (571 males, 361 females) aged between 13 and 63 years old (M 21.75 ± 8.7): 571 college students aged between 18 and 35 years old (M 21.54 ± 2.59), 62 teachers aged between 38 and 63 years old (M 51.18 ± 6.27), and 299 high school students aged between 13 and 19 years old (M 16.05 ± 1.67). Measures were two anonymous questionnaires to collect sociodemographic information and to assess knowledge of, attitudes toward, and perception of epilepsy. Analyses were performed with descriptive statistical analysis (mean, standard deviation, frequency counts, and percentages) and Mann–Whitney U-test nonparametric for two independent samples. This study provides general information about psychosocial aspects of epilepsy in Sicily which provides the basis for further studies and the development of interventions to eliminate prejudices against persons with epilepsy and related myths.

We assessed voluntary orientation and reorientation of visuospatial attention in 313 healthy 6- to 22-year-old participants, 30 children suffering from benign epilepsy with centrotemporal spikes (BECTS) and 13 children with Panayiotopoulos syndrome (PS). The developmental section highlights the late development of reorientingskills. Only childrenwith BECTS-R showed a strong tendency toward a rightward bias in attentional orientation. Additionally, a unilateral deficit of disengagement characterizes the patients with BECTS-R and comorbid ADHD.Right rolandic spikes seem to aggravate subclinical reorienting difficulties. Finally, children with PS failed to diffuse inhibition, except in the nearest area outside the attentional focus. This deficit could be attributed tothe typical occipital-to-frontal spreading of the spikes in PS. By showing distinct attentional deficiencies according to the epileptic syndrome and the epileptic focus lateralization in BECTS, the results provide newevidence for alterations of attentional mechanisms by interictal epileptic activity, which probably contributeto learning difficulties.

CF-1 male mice were trained in an inhibitory avoidance (IA) task. A single gabapentin (GBP) administration (50 mg/kg, ip) immediately after training enhanced retention performance when mice were tested 8 days after training. On the contrary, when the same dose of the anti-convulsant drug was given twice a day for 7 days (repeated treatment), a signiWcant impairment on retention performance 12 h after the last injection of GBP was observed. When the retention test was delayed 7 days after the end of the repeated treatment, the retention performance was not signiWcant diVerent from the control group, whereas if the retention test was delayed 14 days, retention performance was higher than control group but similar to that observed when GBP was administered once immediately after training. The impairment on retention performance was correlated with a signiWcant decrease in the high aYnity choline uptake in the hippocampus at the end of the retention test. The pretest administration of the direct muscarinic cholinergic agonist oxotremorine (50 g/kg, ip) reversed the impairment on retention performance. This reversion was prevented by the muscarinic cholinergic antagonist scopolamine (0.5 mg/kg, ip). Taken together, these results suggest that the impairment on retention performance of an IA task in mice induced by repeated administration of GBP aVected memory retrieval but not memory consolidation and that this impairment may be attributable to a reduction on central cholinergic activity.

The present data indicate that status epilepticus (SE) induced in adult rats is associated with cognitive dysfunctions and cerebral
oxidative stress (OS).This has been demonstrated using lithium-pilocarpine (Li-Pc)model of SE. OS occurring in hippocampus and
striatum of mature brain following SE is apparently due to both the increased free radicals production and the limited antioxidant
defense. Pronounced alterations were noticed in the enzymatic, glutathione-S transferase (GST), catalase (CAT), and superoxide
dismutase (SOD), as well as in the nonenzymatic; thiobarbituric acid (TBARS) and reduced glutathione (GST), indices of OS in the
hippocampus and striatum of SE induced animals. Quinacrine (Qcn), proglumide (Pgm), and pentoxifylline (Ptx) administered to
animals before inducing SE, were significantly effective in ameliorating the seizure activities, cognitive dysfunctions, and cerebral
OS. The findings suggest that all the drugs were effective in the order of Ptx < Pgm < Qcn indicating that these drugs are
potentially antiepileptic as well as antioxidant; however, further studies are needed to establish this fact. It can be assumed that
these antiepileptic substances with antioxidant properties combined with conventional therapies might provide a beneficial effect
in treatment of epilepsy through ameliorating the cerebral OS.

Benign childhood epilepsy with centro-temporal spikes (BCECTS) is a unique form of non-lesional age-dependent epilepsy with rare seizures, focal electroencepalographic abnormalities affecting the same well delineated cortical region in most patients, and frequent mild to moderate cognitive dysfunctions. In this condition, it is hypothesized that interictal electroencepalographic discharges might interfere with local brain maturation, resulting in altered cognition. Diffusion tensor imaging allows testing of this hypothesis by investigating the white matter microstructure, and has previously proved sensitive to epilepsy-related alterations of fractional anisotropy and diffusivity. However, no diffusion tensor imaging study has yet been performed with a focus on BCECTS. We investigated 25 children suffering from BCECTS and 25 age-matched control subjects using diffusion tensor imaging, 3D-T 1 magnetic resonance imaging, and a battery of neuropsychological tests including Conner's scale and Wechsler Intelligence Scale for Children (fourth revision). Electroencephalography was also performed in all patients within 2 months of the magnetic resonance imaging assessment. Parametric maps of fractional anisotropy, mean-, radial-, and axial diffusivity were extracted from diffusion tensor imaging data. Patients were compared with control subjects using voxel-based statistics and family-wise error correction for multiple comparisons. Each patient was also compared to control subjects. Fractional anisotropy and diffusivity images were correlated to neuropsychological and clinical variables. Group analysis showed significantly reduced fractional anisotropy and increased diffusivity in patients compared with control subjects, predominantly over the left pre-and postcentral gyri and ipsilateral to the electroencephalographic focus. At the individual level, regions of significant differences were observed in 10 patients (40%) for anisotropy (eight reduced fractional anisotropy, one increased fractional anisotropy, http://brain.oxfordjournals.org/ Downloaded from one both), and 17 (56%) for diffusivity (13 increased, one reduced, three both). There were significant negative correlations between fractional anisotropy maps and duration of epilepsy in the precentral gyri, bilaterally, and in the left postcentral gyrus. Accordingly, 9 of 12 patients (75%) with duration of epilepsy 412 months showed significantly reduced fractional anisotropy versus none of the 13 patients with duration of epilepsy 412 months. Diffusivity maps positively correlated with duration of epilepsy in the cuneus. Children with BCECTS demonstrate alterations in the microstructure of the white matter, undetectable with conventional magnetic resonance imaging, predominating over the regions displaying chronic interictal epileptiform discharges. The association observed between diffusion tensor imaging changes, duration of epilepsy and cognitive performance appears compatible with the hypothesis that interictal epileptic activity alters brain maturation, which could in turn lead to cognitive dysfunction. However, such cross-sectional association does not demonstrate causality, and other hitherto unidentified factors could represent the common cause to part or all of the observed findings. Abbreviations: BCECTS = benign childhood epilepsy with centro-temporal spikes; DTI = diffusion tensor imaging; SPM = statistical parametric mapping; WISC = Wechsler Intelligence Scale for Children 2 | Brain 2014: Page 2 of 12 C. Ciumas et al. at INIST-CNRS on March 9, 2014 http://brain.oxfordjournals.org/ Downloaded from m = months; y = years; C-T = centro-temporal; T = temporal; C-P = centro-parietal; C-T-P = centro-temporo-parietal; F-C-T = fronto-centro-temporal; M = male; F = female; AED = antiepileptic drug; LEV = levetiracetam; VAL = sodium valproate; CLO = clobazam; CBZ = carbamazepine; LAM = lamotrigine. Running title: White matter development in rolandic epilepsy Brain 2014: Page 3 of 12 | 3 at INIST-CNRS on March 9, 2014 http://brain.oxfordjournals.org/ Downloaded from 4 | Brain 2014: Page 4 of 12 C. Ciumas et al. at INIST-CNRS on March 9, 2014 http://brain.oxfordjournals.org/ Downloaded from FWE P = 0.05, k = 5; x, y, z = coordinates for the local maxima of the cluster. Running title: White matter development in rolandic epilepsy Brain 2014: Page 5 of 12 | 5 at INIST-CNRS on March 9, 2014 http://brain.oxfordjournals.org/ Downloaded from 6 | Brain 2014: Page 6 of 12 C. Ciumas et al. at INIST-CNRS on March 9, 2014 http://brain.oxfordjournals.org/ Downloaded from FWE P 5 0.05, k = 5; x, y, z = coordinates for the local maxima of the cluster. Running title: White matter development in rolandic epilepsy Brain 2014: Page 7 of 12 | 7

Fixation-off sensitivity (FOS) is a rare phenomenon elicited by elimination of central vision and fixation, which even in the presence of light induces occipital paroxysms or generalized paroxysmal discharges. It is most commonly encountered in patients with idiopathic childhood occipital epilepsies but may also be observed in cases of symptomatic focal and generalized epilepsies. We describe a female Emirati child with Panayiotopoulos syndrome who exhibited FOS in addition to the reverse phenomenon called " inverted fixation-off sensitivity, " in which the electroencephalographic discharges were suppressed by the absence of central vision or fixation and activated by central vision or fixation.

The study was performed to characterize GASH:SAL audiogenic seizures as true epileptic activity based on electroencephalographic markers acquired with a wireless implanted radiotelemetry system. We analyzed cortical EEG patterns synchronized with video recordings of convulsive behavior of the GASH:Sal hamster following an acoustic stimulus. All GASH:Sal presented archetypal motor symptoms comparable to current animal models of generalized tonic—clonic epilepsy. Seizures consisted of an initial bout of wild running, followed by opistho-tonus, tonic—clonic convulsions, tonic limb extension, and terminated in postictal depression. EEG patterns correlated with behavior and displayed phase appropriate spike—wave complexes , low-amplitude desynchronized activity, and high frequency large-amplitude peaks. Our results confirm that electroencephalographic profiles of the audiogenic seizures of the ham-ster GASH:Sal are parallel to EEG patterns of other animal models of generalized tonic—clonic seizures. Therefore, this animal may serve as an appropriate model for epilepsy research.

The entorhinal cortex (EC) is the key input and output structure of the hippocampus. It plays a crucial role in sensory processing, memory and learning, as well as in mechanisms of epileptic seizures. Our previous studies on the 4-aminopyridin induced epilepsy model of rats showed that ablation of unilateral EC prompted weakening of limbic seizure manifestation, thus the possibility of therapeutical benefit of this kind of surgery can be risen.