Ictal affective symptoms in temporal lobe epilepsy are related to gender and age.

PURPOSE: We systematically analyzed the video-recorded and patient-reported, as well as positive and negative ictal affective symptoms (IAS) in temporal lobe epilepsy (TLE). Our aim was to assess (1) frequency, (2) gender effect, (3) lateralizing significance, (4) localizing value, and (5) prognostic significance in epilepsy surgery of IAS in patients with video-registered seizures. METHODS: We reviewed ictal video recordings of 184 patients (99 women, aged 16-63). All patients had surgery for intractable TLE with video-recorded complex partial seizures (CPS) due to temporal lobe lesions visualized by high-resolution magnetic resonance imaging (MRI). Affective auras (AAs) were categorized into two groups: positive or negative. RESULTS: We registered AAs in 18% of patients: positive in 3%, negative in 15%. We saw ictal affective behavior (IAB) in 22% of patients; 10% had positive, whereas 14% had negative IAB. Two patients had both positive and negative IAB. AAs showed an association with IAB in case of fear expression versus fear auras (p = 0.018). IAB, especially negative IAB, occurred more often in women than in men. Patients with negative IAB were younger than others. We could not demonstrate an association between IAS and the localization, lateralization, or hemispheric dominance. Surgical outcome did not associate with IAS. DISCUSSION: Patient-reported and video-recorded negative-but not positive-affective signs are related to each other. Video-recorded negative AAs occur more often in women and young patients.

Ictal vocalizations occur more often in temporal lobe epilepsy with dominant (left-sided) epileptogenic zone.

OBJECTIVE: To investigate the lateralization value of ictal vocalizations in temporal lobe epilepsy (TLE). METHODS: We reviewed video-recordings of 97 patients who had undergone presurgical evaluation programs with video-EEG (electroencephalography)-recorded complex partial seizures (CPS) and high-resolution magnetic resonance imaging (MRI). All patients had surgery due to TLE and became seizure-free. In 57 patients, determination of speech dominance was necessary by using Wada tests or functional MRI (fMRI). To reevaluate the archived seizures, we reviewed one to three consecutively recorded CPS of each patient. Altogether 223 archived seizures were analyzed. Ictal vocalization was considered to be present in a particular patient if it occurred in at least one of the recorded seizures. RESULTS: Ictal vocalizations occurred in 22 patients. They occurred in 37% of left-sided and in 11% of right-sided patients with TLE (p = 0.003). In patients with determined speech lateralization, ictal vocalizations occurred in 37% of the dominant and in 14% in patients with nondominant epileptogenic zone (p = 0.04). In patients with ictal vocalizations, epilepsy began at age 8.7 +/- 6, whereas in the remaining patients, epilepsy started at age 14.0 +/- 9 (p = 0.017). Logistic regression showed that both hemispheric dominance and age at onset were independently associated with pure ictal vocalization (PIV). CONCLUSIONS: Ictal vocalization is a frequent phenomenon, occurring in 23% of patients with TLE. It is more often associated with left-sided and early onset TLE. Our results may improve the lateralization of the epileptogenic zone and suggest that nonspeech vocalizations in humans are related to the dominant (left-sided) hemisphere. Our study is a further argument that there are different subtypes of TLE depending on the age at onset.

[Effect of epileptic seizures on the heart rate]. / Az epilepsziás rohamok hatása a szívfrekvenciára.

BACKGROUND: Sudden death appears in 8-17% of epilepsy patients non-responding to antiepileptic therapy. Some studies suggest that the most common cause of death is seizure-related cardiac arrhythmia. AIM OF STUDY: To analyze the alteration of the heart rate six hours before and after the seizures. METHODS: Eighteen patients suffering from focal epilepsy were examined before epilepsy surgery. Video-EEG-ECG was carried out for 2-10 days, and 32 seizures were registered. Analysis of the heart rate was based on the 5-minute-long epochs of the ECGs taken at the 5-10-15-30th minutes and at the 1-3-6th hours before and after seizures. RESULTS: The heart rate increases (from an average of 69 beats/min to 92 beats/min, p<0.001) immediately after seizures, though significantly higher heart rate was observed 3 hours after seizures. There were no patients with severe peri-ictal bradycardia. In one of our patients, ectopic cardiac rhythm occurred after a generalized tonic-clonic seizure. CONCLUSIONS: We can conclude that the sympathetic activity increases while the parasympathetic activity decreases after seizures. The observed alterations lasted for a long time and predict fatal arrhythmias. These suggest that sudden death in epilepsy can be induced by cardiac arrhythmias connected with epileptic seizures.

Juvenile myoclonic epilepsy starting in the eighth decade.

Juvenile myoclonic epilepsy (JME) typically begins at age 10-17 years. We present two patients, with no previous history of epileptic seizures, in whom JME began after the age of 70. The clinical picture of these patients did not differ from "typical" JME except for the patient's age and age at epilepsy-onset. We suggest that not only symptomatic epilepsy, but also some idiopathic epilepsies, can begin or can be reactivated in elderly people. This may be more evidence that susceptibility to epileptic seizures is increased after 60 years of age.

Peri-ictal water drinking in temporal lobe epilepsy: Is it a reliable lateralizing sign?

Peri-ictal water drinking has been reported to be a lateralizing sign to the right side in temporal lobe epilepsy (TLE). As peri-ictal water drinking is relatively common in our own patients with TLE, we wanted to evaluate its lateralization value for ourselves. We reviewed the data for 55 adult patients with TLE who had undergone epilepsy surgery with a favorable postoperative outcome in our center. Eight patients exhibited peri-ictal water drinking behavior. Five of them had a left temporal and three a right temporal epileptogenic region. We also analyzed cases of peri-ictal water drinking in the literature and found that the reported data do not support this behavior as a laterality indicator. In conclusion, we could not find any evidence for the lateralization value of peri-ictal water drinking in TLE.

Avaliação In vitro e histológica da interação do cloreto de cetiltrimetilamônio com peles de diferentes etnias / In vitro evaluation and histological of the interaction of cetiltrimetilamus chloride with skins of different colors

Com o advento do século XXI e a globalização, o conceito de beleza tornou-se uma fronteira sem limites. A utilização da engenharia genética, a reestruturação do genoma, da tecnologia virtual, visual e a nanotecnologia, inseriu na indústria cosmética e cosmecêutica uma nova visão de competitividade e exigência de um mercado, que poderia denominar-se de "sensorial/digital". O grande modelo responsável por este processo inovador, é sem dúvida alguma a pele, a imagem da aparência externa somados aos mecanismos internos da homeostasia, identifica a arquitetura humana e performance social...