Precipitation and inhibition of seizures in focal epilepsies

Mameniškienė, Rūta; Wolf, Peter

doi:10.1080/14737175.2018.1455502

Cited by 12 publications

(14 citation statements)

References 108 publications

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“…An incidence of 1:1000 to 1:2000 of seizures induced by eating is reported in all epileptic patients [8,29]. Eating-induced seizures may be symptomatic or genetic and of variable semiology [30]. The description of 20 subjects out of nine families with 59 family members from Sri Lanka, who showed eating-triggered seizures, provided the first preliminary evidence of a genetic etiology for eating seizures.…”

Section: Discussionmentioning

confidence: 97%

Chewing induced reflex seizures (“eating epilepsy”) and eye closure sensitivity as a common feature in pediatric patients with SYNGAP1 mutations: Review of literature and report of 8 cases

Stülpnagel

Hartlieb

Borggräfe³

et al. 2019

Seizure

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Heterozygous SYNGAP1 gene mutations have been associated with several forms of idiopathic generalized epilepsy, autism spectrum disorders and delay of psychomotor development. We report eight patients with a SYNGAP1 mutation and chewing/eating induced reflex seizures as new phenotype and compare them to other patients with eating epilepsy and genetic mutations. Methods: Presentation of clinical and anamnestic features and retrospective analysis of Video-EEG data of a 4 year old index patient with SYNGAP1 mutation and chewing /eating induced seizures. Clinical and anamnestic features and home videos of seven additional patients (4 female; age: 4-14 years) with SYNGAP1 mutation and eating induced reflex seizures were compared. Results: All reflex seizures of the index patient showed similar focal EEG pattern with 1-5 seconds high amplitude, irregular 3/sec spike-wave complexes with initiation from left temporo-occipital, right temporo-occipital or bi-occipital / temporo-occipital regions. Eyelid myoclonia, the most common seizure type in all 8 patients, were typically initiated by eating or other simple orofacial stimuli. In the index patient eye closure preceded eating induced-eyelid myoclonia in 30/38 seizures. Conclusion:The main clinical features of our patient (i.e. intellectual disability, epilepsy, autistic features) are compatible with previous reports on patients with SYNGAP1 mutations. This is the first complete description of

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Section: Discussionmentioning

confidence: 97%

Chewing induced reflex seizures (“eating epilepsy”) and eye closure sensitivity as a common feature in pediatric patients with SYNGAP1 mutations: Review of literature and report of 8 cases

Stülpnagel

Hartlieb

Borggräfe³

et al. 2019

Seizure

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“…sudden noises, flashing lights, tapping and other tactile stimuli (for a review see Trenité, 2012). A review covering a range of sensory-evoked focal seizures emphasized the anatomical epileptic focus and its abnormal neuronal activity as key predictors of sensory triggers (Mameniškienė and Wolf, 2018). In accordance with this statement, our results demonstrated a change in the response to whisker-pad stimulation under the influence of CNO (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Animal and human studies show that sensory stimulation can trigger epileptic events (Mameniškienė and Wolf, 2018). Examination of the effect of inhibition silencing on the response to sensory stimuli was carried out by providing contralateral whisker pad stimulation to mice expressing hM4D at the BC before and after CNO administration.…”

Section: Sensory-evoked Epileptiform Activitymentioning

confidence: 99%

Localized Chemogenetic Silencing of Inhibitory Neurons: A novel Mouse Model of Focal Cortical Seizures

Schmidt

Mitelman

et al. 2020

Preprint

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Focal cortical epilepsies are frequently refractory to available anticonvulsant drug therapies. One key factor contributing to this state is the limited availability of animal models that allow to reliably study focal cortical seizures and how they recruit surrounding brain areas in-vivo. In this study, we selectively expressed the inhibitory chemogenetic receptor, hM4D, in GABAergic neurons in focal cortical areas using viral gene transfer. Following focal silencing of GABAergic neurons by administration of Clozapine-N-Oxide (CNO), we demonstrated reliable induction of local epileptiform events in the electroencephalogram (EEG) signal of awake freely moving mice. Experiments in anesthetized mice showed consistent induction of focal seizures in two different brain regions - the barrel cortex (BC) and at the medial prefrontal cortex (mPFC). Seizures were accompanied by high frequency oscillations, a known characteristic of human focal seizures. Seizures propagated, but an analysis of seizure propagation revealed favored propagation pathways. CNO-induced epileptiform events propagated from the BC on one hemisphere to its counterpart and from the BC to the mPFC, but not vice-versa. Lastly, post-CNO epileptiform events in the BC could be triggered by sensory whisker-pad stimulation, indicating that this model, applied to sensory cortices, may be useful to study sensory-evoked seizures. Taken together, our results show that targeted chemogenetic inhibition of GABAergic neurons using hM4D can serve as a novel, versatile and reliable model of focal cortical epilepsy suitable to systematically study cortical ictogenesis in different cortical areas.

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“…In consequence, we wondered whether cognitive stimuli should become a part of the standard EEG protocol in epilepsy or suspected epilepsy patients. Besides, the effect of cognitive stimuli on IEDs in focal epilepsies needs clarification, since most relevant studies on the topic dealt only with generalized epilepsies [14]. Therefore, we carried out a prospective multicentre field study of an unselected cohort of epilepsy patients, in which a limited number of cognitive tasks were included in the standard EEG protocol.…”

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confidence: 99%

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confidence: 99%

Cognitive tasks as provocation methods in routine EEG: a multicentre field study

Braga

Mameniškienė

Guaranha

et al. 2021

Epileptic Disorders

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Objective. This study aimed to analyse the effect of neuropsychological activation methods on interictal epileptiform discharges, compared to standard activation methods, for both focal and generalized epilepsies. Methods. This was a multicentre, prospective study including 429 consecutive EEG recordings of individuals with confirmed or suspected diagnosis of epilepsy. Neuropsychological activation included reading aloud in foreign and native language, praxis and a letter cancelation task (each with a duration of three minutes). After counting interictal discharges in three-minute time windows, activation and inhibition were assessed for each procedure, accounting for spontaneous fluctuations (95% CI) and compared to the baseline condition with eyes closed. Differences between generalized and focal epilepsies were explored. Results. Interictal epileptiform discharges were present in 59.4% of the recordings. Activation was seen during hyperventilation in 31%, in at least one neuropsychological activation method in 15.4%), during intermittent photic simulation in 13.1% and in the resting condition with eyes open in 9.9%. The most frequent single cognitive task eliciting activation was praxis (10.3%). Lasting activation responses were found in 18-25%. Significant inhibition was found in 88/98 patients with baseline interictal epileptiform discharges, and was not task-specific. Significance. Adding a brief neuropsychological activation protocol to the standard EEG slightly increased its sensitivity in patients with either focal or generalized epilepsy. However, in unselected epilepsy patients, this effect seems only exceptionally to result in ultimate diagnostic gain, compared to standard procedures. From a diagnostic perspective, cognitive tasks should be reserved for patients with a suspicion of cognitive reflex epilepsy/seizures and probably require longer exposure times. Further research is needed to explore potential therapeutic applications of the observed inhibition of interictal epileptiform discharges by cognitive tasks in some patients.

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Precipitation and inhibition of seizures in focal epilepsies

Cited by 12 publications

References 108 publications

Chewing induced reflex seizures (“eating epilepsy”) and eye closure sensitivity as a common feature in pediatric patients with SYNGAP1 mutations: Review of literature and report of 8 cases

Chewing induced reflex seizures (“eating epilepsy”) and eye closure sensitivity as a common feature in pediatric patients with SYNGAP1 mutations: Review of literature and report of 8 cases

Localized Chemogenetic Silencing of Inhibitory Neurons: A novel Mouse Model of Focal Cortical Seizures

Cognitive tasks as provocation methods in routine EEG: a multicentre field study

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