[Hot-water epilepsy: case report in an infant]. / Epilepsia refleja por agua caliente: a propósito de un caso en un lactante.

Hot-water epilepsy is a rare type of seizure whose pathophysiology is unknown. These reflex seizures usually begin a few seconds after contact with water, commonly at temperatures between 37-48 ºC. Automations and complex partial crises, with or without secondary generalization, are the main manifestation mode of this type of reflex epilepsies. Neurological examination and intercritical electroencephalography are usually normal, which may condition a delay in diagnosis, and the clinical suspicion is fundamental. Antiepileptic treatment is initiated when associated with another type of epilepsy or when certain simple measures, such as lowering the water temperature in the bath, do not control crises. Spontaneous disappearance is possible; when pharmacological therapy is necessary, there is usually a good response. We present the case of an infant diagnosed with hot-water epilepsy. Key words: seizures, reflex epilepsies, hot water-induced reflex epilepsy.

La epilepsia refleja por agua caliente es un tipo de convulsión poco frecuente cuya fisiopatología se desconoce. Estas crisis reflejas suelen iniciarse pocos segundos tras el contacto con el agua y, comúnmente, a temperaturas de 37-48 ºC. Los automatismos y las crisis parciales complejas, con o sin generalización secundaria, son el modo de manifestación principal. La exploración neurológica y el electroencefalograma intercrítico no suelen presentar alteraciones, lo que puede condicionar un retraso en el diagnóstico, por lo que es fundamental la sospecha clínica. El tratamiento antiepiléptico se inicia cuando se asocia a otro tipo de epilepsia o cuando ciertas medidas sencillas, como el descenso de la temperatura del agua en el baño, no controlan las crisis. Es posible la desaparición espontánea. Cuando es necesaria la terapéutica farmacológica, existe, normalmente, buena respuesta. Se presenta el caso de un lactante con diagnóstico de epilepsia refleja por agua caliente.

Functional characterization of the hypothalamic-pituitary-adrenal axis of the Wistar Audiogenic Rat (WAR) strain.

The Wistar Audiogenic Rat (WAR) strain is a genetic model of sound-induced reflex epilepsy which was selected starting from audiogenic seizures susceptible Wistar rats. Wistar resistant rats were used as WAR's control in this study. In the acute situation, audiogenic seizures (AS) in WARs mimic tonic-clonic seizures and, in the chronic protocol, mimic temporal lobe epilepsy. AS have been shown to evoke neuroendocrine responses; however, the hypothalamic-pituitary-adrenal activity in the WAR has not been established. The aim of this study was to evaluate the hypothalamic-pituitary-adrenal axis (HPA) responses to exogenous ACTH stimulation (8 ng/rat), fifteen minute restraint stress and circadian variation (8 am and 8 pm) under rest conditions in these animals through plasma measurements of ACTH and corticosterone concentrations. We also measured the body weight from birth to the 9th week of life and determined adrenal gland weight. We found that WARs are smaller than Wistar and presented a higher adrenal gland weight with a higher level of corticosterone release after intravenous ACTH injection. They also showed altered HPA axis circadian rhythms and responses to restraint stress. Our data indicate that, despite the lower body weight, WARs have increased adrenal gland weight associated with enhanced pituitary and adrenal responsiveness after HPA axis stimulation. Thus, we propose WARs as a model to study stress-epilepsy interactions and epilepsy-neuropsychiatry comorbidities.

Language- and praxis-induced jerks in patients with juvenile myoclonic epilepsy.

Reflex traits have been described in patients with idiopathic generalized epilepsy. We report on four patients with juvenile myoclonic epilepsy in whom the coexistence of praxis- and language-induced jerks was documented in video-polygraphic EEG recordings.[Published with video sequences].

Photosensitivity: the magnitude of the problem.

Very few studies of photosensitivity or visual sensitive epilepsy could be called epidemiologic in the strict sense, that is, giving well-based incidence and prevalence rates of a well-defined clinical and electroencephalographic syndrome or group of syndromes. The available data suggest that photosensitivity is rare in the population as a whole, with an annual incidence rate around one case per 100,000 population. The incidence goes up to almost six per 100,000 in the late adolescent period, the age group at the highest risk. Well-established concepts, such as statements that one in 4,000 of the general population or that 10% of all epilepsy patients would be photosensitive, should be reevaluated. The more likely figures are a lifetime prevalence of one in 10,000 in the general population, perhaps as low as 2%, of the epilepsy population. Further epidemiologic studies, sensu strictu, are warranted to settle the basic question of the real incidence and prevalence of photoparoxysmal responses (PPRs) and epilepsy with seizures provoked by visual stimuli in the community.

A critical review on the participation of inferior colliculus in acoustic-motor and acoustic-limbic networks involved in the expression of acute and kindled audiogenic seizures.

The main goal of this article is to review the key role that the inferior colliculus plays in the expression of acoustic-motor and acoustic-limbic integration involved, respectively, in acute and chronic audiogenic seizures. In order to put this in context, we will review the behavioral characterization of acute and chronic audiogenic seizures, neuroanatomical substrates, neurochemistry, neuropharmacology, electrophysiology, as well as the cellular and molecular mechanisms involved in their expression. Secondly, we will also correlate our results, collected from audiogenic seizures susceptible rats, before and after the genetic selection of our own audiogenic susceptible strain, and from those sensitized by lesions or drug microinjections, with those pertinent from the international literature. In brief, genetic or sensitized animals express acute audiogenic seizures as a wild running behavior preceding the onset of tonic-clonic seizures. The latter can have several presentations including opistotonus and fore- and hindlimb tonic hyperextensions, followed by clonic convulsions of fore- and hindlimbs. Chronic (kindled) audiogenic seizures change this behavioral expression, with similar patterns such as those present in temporal lobe epileptic seizures, intermingled with the original audiogenic seizure pattern, which is known to be dependent on brainstem networks.