Bilateral stereotactic radiofrequency amygdalohippocampectomy for the treatment of bilateral medial temporal lobe epilepsy / 实用医学杂志

Objective To retrospectively analyze the effect and safety of bilateral stereotactic radiofrequency amygdalohippocampectomy (SAHE) for treatment of bilateral medial temporal lobe epilepsy (BMTLE). Methods Twelve BMTLE patients were treated with bilateral SAHE under limited coagulations. Clinical parameters were evaluated with the programs of Engel′s classification, Liverpool Seizure Severity Scale (LSSS) 2.0, Wechsler Adult Intelligence Scale-Revised (WAIS-R) and Wechsler Memory Scale-Revised (WMS-R), respectively. Results Five patients (42%) were assessed as EngelⅠwith 12 ~ 62-month follow-up. Seizure severity scores were declined sharply compared with the baseline of the patients with out seizure free. Function of memory and intelligence was transiently declined without statistical significance immediately after operation (P >0.05), but was significantly increasedat 6 months after operation (P < 0.05). Conclusion Bilateral SAHE could terminate seizures or reduce seizure severity in patients with BMTLE. Under the circumstance of limited coagulations, neuropsychological function was improved along with seizure control.

Correlation between peripheral blood inflammatory cytokines and kainic acid-induced seizure severity in rats / 中华行为医学与脑科学杂志

Objectives To investigate the correlation between the level of peripheral blood inflammatory cytokines and kainic acid-induced seizure severity in rats.Methods 140 rats were divided into control and model group randomly,70 rats in each group.Model group rats were injected with kainic acid (10 mg/kg) by intraperitoneal,and the control rats were injected with sodium chloride.The change of their behaviors was observed and the concentrations of TNF-α,IL-1β,IL-4 and IL-10 were determined by ELISA in each group at different times.Results The rats showed epilepsy grand mal in 3 h-9 h after KA injection.The concentrations of TNF-α and IL-1β in model groups were significantly higher than those in control group in 6 h-12 h (6 h:(21.5±3.2) pg/ml vs (12.3±3.1)pg/ml;12 h:(20.6±4.2)pg/ml vs (11.5±3.8)pg/ml)(P＜0.05) and IL-4 in model group was higher at only 12 h ((53.55±3.08) pg/ml vs (33.26±4.16)pg/ml) (P＜0.05).The level of IL-10 in model groups was not statistically significant compared with control group (P＞0.05).Conclusion The proinflammatory cytokines (TNF-α and IL-l β) participate in the seizure procedure,meanwhile their levels and seizure severity have eminent correlations,but antiinflammatory cytokines (IL-4 and IL-10) had not.

Relationship between Serum Levels of Homocysteine and Folate and Seizure Severity in Patients with Idiopathic Epilepsy / 대한간질학회지

BACKGROUND AND PURPOSE: High serum homocysteine level is recognised as one of risk factors for epileptic seizure. Folate is involved in the homocysteine metabolism and low serum folate level increases the frequency of the seizure activity. The purpose of this study is to examine the changes of the serum levels of homocysteine and folate in epileptic patients and to evaluate the correlation between the severity of seizure and serum levels of homocysteine and folate. METHOD: Subjects were 17 patients who were diagnosed as idiopathic epilepsy and the control group was composed of age and sex matched 17 healthy adults. The serum homocysteine level was measured with the Chemiluminescent Immunoassay (CLIA), and folate level was measured with Radioimmuno assay (RIA). The severity of seizure was measured by using National Hospital Seizure Scale. RESULTS: The serum level of homocysteine was significantly higher in the patients group than in control group. However, the serum level of folate was not different between two group. The relationship between the seizure severity and the serum levels of homocysteine and folate showed positive correlations. CONCLUSIONS: There results reveal that the serum homocysteine may effect on the epileptic seizure severity.

The Protective Effect of Chlorpromazine on Pentylenetetrazole Induced Seizure / 대한소아신경학회지

PURPOSE: Chlorpromazine(CPZ) is known to inhibit glutamate dehydrogenase(GDH). Reductive amination of alpha-ketoglutarate is catalyzed by GDH and forms glutamate, a major excitatory neurotransmitter. Thus, we hypothesized that CPZ might have a seizure-protective effect by inhibition of glutamate release from the excitatory presynaptic nerve terminal. The present study was designed to investigate the protective effect of CPZ on pentylenetetrazole(PTZ)-induced seizure in rats. METHODS: Twenty male Sprague-Dawley rats were equally divided into 2 groups. CPZ(20 mg/kg) was administered to experimental animals by subcutaneous injection, while normal saline to control animals. Twenty minutes later, seizures were chemically induced by intraperitoneal injection of PTZ(60 mg/kg). Seizure severity was evaluated by using a scoring system of seizure behaviors:0, no seizure; 0.5, abnormal behavior; 1, myoclonic jerk; 2, myoclonic jerk with jumping; 3, forelimb clonus with preserving righting reflex; 4, generalized clonic seizure with brief loss of righting reflex; 5, generalized tonic clonic seizure; 6, expire. A greater score represents a more severe seizure. RESULTS: The seizure behavior scores(2.8+/-0.2) in the experimental group were significantly lower than those(3.9+/-0.4) in the control group(P<0.05). CONCLUSION: This study demonstrates that CPZ decrease PTZ-induced seizure severity in rats. Our results suggest that CPZ may have a seizure-protective effect. We hope that further studies on this issue should be performed in near future.

The Protective Effect of Chlorpromazine on Pentylenetetrazole Induced Seizure / 대한소아신경학회지

PURPOSE: Chlorpromazine(CPZ) is known to inhibit glutamate dehydrogenase(GDH). Reductive amination of alpha-ketoglutarate is catalyzed by GDH and forms glutamate, a major excitatory neurotransmitter. Thus, we hypothesized that CPZ might have a seizure-protective effect by inhibition of glutamate release from the excitatory presynaptic nerve terminal. The present study was designed to investigate the protective effect of CPZ on pentylenetetrazole(PTZ)-induced seizure in rats. METHODS: Twenty male Sprague-Dawley rats were equally divided into 2 groups. CPZ(20 mg/kg) was administered to experimental animals by subcutaneous injection, while normal saline to control animals. Twenty minutes later, seizures were chemically induced by intraperitoneal injection of PTZ(60 mg/kg). Seizure severity was evaluated by using a scoring system of seizure behaviors:0, no seizure; 0.5, abnormal behavior; 1, myoclonic jerk; 2, myoclonic jerk with jumping; 3, forelimb clonus with preserving righting reflex; 4, generalized clonic seizure with brief loss of righting reflex; 5, generalized tonic clonic seizure; 6, expire. A greater score represents a more severe seizure. RESULTS: The seizure behavior scores(2.8+/-0.2) in the experimental group were significantly lower than those(3.9+/-0.4) in the control group(P<0.05). CONCLUSION: This study demonstrates that CPZ decrease PTZ-induced seizure severity in rats. Our results suggest that CPZ may have a seizure-protective effect. We hope that further studies on this issue should be performed in near future.

A Study on the Age-Dependent Antiepileptic Effects of the Ketogenic Diet in the Pentylenetetrazole-Seizure Animal Model / 대한소아신경학회지

PURPOSE: The ketogenic diet(KD) has been felt to be clinically more efficacious at younger ages, presumably because of the enhanced ability of the immature brain to extract and utilize ketone bodies. The present study was designed to investigate age-dependent effects of the KD on pentylenetetrazole(PTZ)-seizure severity in rats. METHODS: A KD([fat]:[protein+carbohydrate] ratio of 4.3:1) was administered to male Sprague-Dawley rats for 3 weeks, while control animals were fed a standard rodent chow. Dietary treatment was initiated at either postnatal 9 or 12 weeks. Seizures were chemically induced by intraperitoneal injection of PTZ(60 mg/kg) and blood beta-hydroxybutyrate (BHB) levels were assayed on treatment day 21. Seizure severity was evaluated by using a scoring system of seizure behaviors:0, no seizure; 0.5, abnormal behavior; 1, myoclonic jerk; 2, myoclonic jerk with jumping; 3, forelimb clonus with preserving righting reflex; 4, generalized clonic seizure with brief loss of righting reflex; 5, generalized tonic clonic seizure; 6, expire. A greater score represents a more severe seizure. RESULTS: In 9 weeks old rats, the mean(+/-SEM) seizure behavior scores were 3.5+/-1.2 [n=19] and 4.4+/-0.9[n=17] for the KD-treated and control groups, respectively(P<0.05), whereas in 12 weeks old animals, no significant differences in seizure behavior scores between the two groups(3.9+/-0.3[n=17] vs. 4.1+/-0.3[n=16], respectively). Blood BHB levels in the KD-treated group were significantly higher than those of the control group in 9 (1.21+/-0.14[n=19] vs. 0.14+/-0.12[n=17] mM, respectively; P<0.001) and 12(0.64+/-0.08[n=17] vs. 0.18+/-0.02[n=16] mM, respectively; P<0.001) weeks old animals. CONCLUSION: The KD was previously reported to decrease PTZ-seizure severity in 3 weeks old rats. In this study, the KD decreases PTZ-seizure severity in 9 weeks old rats, but is ineffective in 12 weeks old rats. These results parallel clinical experience, where the beneficial effects of the KD are felt to be age-dependent.

Effects of the Ketogenic Diet on Pentylenetetrazole-Induced Seizure / 대한소아신경학회지

PURPOSE: Despite decades of clinical experience with the ketogenic diet(KD), its efficacy and mechanisms of action have been examined in few animal studies. The present study was designed to investigate the effects of the KD on pentylenetetrazole(PTZ)-induced seizure severity in rats. METHODS: Thirty-eight male Sprague-Dawley rats were divided into two equal groups. Dietary treatment was initiated at P22. The KD group was fasted for a day and then fed a KD consisting of a [fat] : [protein+carbohydrate] ratio of 4.3 : 1 for 26 days, while the control group was fed a standard rodent chow. Blood beta-hydroxybutyrate(beta-OHB) levels were assayed on treatment days 0, 20, and 24. Seizures were chemically induced by intraperitoneal injection of PTZ(60mg/kg of body weight) between treatment days 22 and 27. Seizure severity was evaluated by using a scoring system of seizure behaviors : 0, no seizure; 0.5, abnormal behavior; 1, myoclonic jerk; 2, myoclonic jerk with jumping; 3, forelimb clonus with preserving righting reflex; 4, generalized clonic seizure with brief loss of righting reflex; 5, generalized tonic clonic seizure; 6, expire. A greater score represents a more severe seizure. RESULTS: Blood levels of beta-OHB were low(<0.3mM) and showed no significant differences in both groups on day 0. Rats fed the KD developed an increased level of ketosis that was significantly above the levels found in the control group on days 20 and 24 (p<0.001). The KD group(2.37+/-0.27) exhibited significantly(p<0.05) lower seizure score than the control group(3.37+/-0.35). CONCLUSION: The KD was previously reported to increase PTZ-induced seizure thresholds in rats. In our study, rats fed the KD exhibited significantly decreased PTZ-induced seizure scores relative to controls. This suggests that the KD can not only increase the resistance to seizure but also decrease the severity of seizure induced by PTZ.