Coffee consumption and seizure frequency in patients with drug-resistant focal epilepsy.

OBJECTIVE: To assess the relation between coffee consumption and seizure frequency in patients with drug-resistant focal epilepsy. METHODS: Cross-sectional analysis of data collected in the SAVE study, which included patients with drug-resistant focal epilepsy during long-term EEG monitoring. Patients in whom both coffee consumption and data about seizure frequency, including focal to bilateral tonic-clonic seizures (FBTCS), were available were selected. Coffee consumption was collected using a standardized self-report questionnaire and classified into four groups: none, rare (from less than 1 cup/week to up 3 cups/week), moderate (from 4 cups/week to 3 cups/day), and high (more than 4 cups/day). RESULTS: Six hundred and nineteen patients were included. There was no relation between coffee consumption and total seizure frequency (p = 0.902). In contrast, the number of FBTCS reported over the past year was significantly associated with usual coffee consumption (p = 0.029). Specifically, number of FBCTS in patients who reported moderate coffee consumption was lower than in others. In comparison with patients with moderate coffee consumption, the odds ratio (95%CI) for reporting at least 1 FBTCS per year was 1.6 (1.03-2.49) in patients who never take coffee, 1.62 (1.02-2.57) in those with rare consumption and 2.05 (1.24-3.4) in those with high consumption. Multiple ordinal logistic regression showed a trend toward an association between coffee consumption and number of FBTCS (p = 0.08). CONCLUSIONS AND RELEVANCE: Our data suggest that effect of coffee consumption on seizures might depend on dose with potential benefits on FBTCS frequency at moderate doses. These results will have to be confirmed by prospective studies.

Hypoxemia following generalized convulsive seizures: Risk factors and effect of oxygen therapy.

OBJECTIVE: To analyze the factors that determine the occurrence or severity of postictal hypoxemia in the immediate aftermath of a generalized convulsive seizure (GCS). METHODS: We reviewed the video-EEG recordings of 1,006 patients with drug-resistant focal epilepsy included in the REPO2MSE study to identify those with ≥1 GCS and pulse oximetry (SpO2) measurement. Factors determining recovery of SpO2 ≥ 90% were investigated using Cox proportional hazards models. Association between SpO2 nadir and person- or seizure-specific variables was analyzed after correction for individual effects and the varying number of seizures. RESULTS: A total of 107 GCS in 73 patients were analyzed. A transient hypoxemia was observed in 92 GCS (86%). Rate of GCS with SpO2 <70% dropped from 40% to 21% when oxygen was administered early (p = 0.046). Early recovery of SpO2 ≥90% was associated with early administration of oxygen (p = 0.004), absence of postictal generalized EEG suppression (PGES) (p = 0.014), and extratemporal lobe epilepsy (p = 0.001). Lack of early administration of O2 (p = 0.003), occurrence of PGES (p = 0.018), and occurrence of ictal hypoxemia during the focal phase (p = 0.022) were associated with lower SpO2 nadir. CONCLUSION: Postictal hypoxemia was observed in the immediate aftermath of nearly all GCS but administration of oxygen had a strong preventive effect. Severity of postictal hypoxemia was greater in temporal lobe epilepsy and when hypoxemia was already observed before the onset of secondary GCS.

New dating evidence of the early presence of hominins in Southern Europe.

The first "Out of Africa" migrations represent a seminal event in the history of humankind. At the gates of Europe, the first appearance of Hominins is recorded in Georgia, 1.8 million years ago (Ma); however, the picture of migration across the continent remains incomplete. Vallonnet Cave (France) is a Lower Paleolithic prehistoric site with traces of hominin activities including lithic remains and cut-marks on mammal bones. Here, we apply the uranium-lead (U-Pb) methods to two flowstones to date the intervening archaeological levels. The U-Pb data, coupled with paleomagnetic constraints, provide an age range from 1.2 to 1.1 Ma. The results conclusively demonstrate that Vallonnet Cave is one of the oldest European prehistoric sites in France with early hominin occupations associated with an Epivillafranchian fauna. Combined with data from other archaeological sites, the new precise chronology suggests a widespread occupation the Northern Mediterranean to Southwestern Europe at ~1.2 Ma.

Application of U/Th and 40Ar/39Ar dating to Orgnac 3, a Late Acheulean and Early Middle Palaeolithic site in Ardèche, France.

Refined radio-isotopic dating techniques have been applied to Orgnac 3, a Late Acheulean and Early Middle Palaeolithic site in France. Evidence of Levallois core technology appeared in level 4b in the middle of the sequence, became predominant in the upper horizons, and was best represented in uppermost level 1, making the site one of the oldest examples of Levallois technology. In our dating study, fourteen speleothem samples from levels 7, 6 and 5b, were U/Th-dated. Four pure calcite samples from the speleothem PL1 (levels 5b, 6) yield ages between 265 ± 4 (PL1-3) and 312 ± 15 (PL1-6) thousand years ago (ka). Three samples from the top of a second stalagmite, PL2, yield dates ranging from 288 ± 10 ka (PL2-1) to 298 ± 17 ka (PL2-3). Three samples from the base of PL2 (level 7) yield much younger U/Th dates between 267 and 283 ka. These dates show that the speleothems PL1 and PL2 are contemporaneous and formed during marine isotope stage (MIS) 9 and MIS 8. Volcanic minerals in level 2, the upper sequence, were dated by the (40)Ar/(39)Ar method, giving a weighted mean of 302.9 ± 2.5 ka (2σ) and an inverse isochron age of 302.9 ± 5.9 ka (2σ). Both (40)Ar/(39)Ar dating of volcanic sanidines and U/Th dating of relatively pure and dense cave calcites are known to be well established. The first parallel application of the two geochronometers to Orgnac 3 yields generally consistent results, which point to the reliability of the two methods. The difference between their age results is discussed.